Racial/Ethnic Disparities in the Association Between Preeclampsia Risk Factors and Preeclampsia Among Women Residing in Hawaii.

Abstract

Objective To assess differences in the rates of preeclampsia among a multiethnic population in Hawaii. Methods We performed a retrospective study on statewide inpatient data for delivery hospitalizations in Hawaii between January 1995 and December 2013. Multivariable logistic regression was used to assess the impact of maternal race/ethnicity on the rates of preeclampsia after adjusting for age, multiple gestation, multiparity, chronic hypertension, pregestational diabetes, obesity and smoking. Results A total of 271,569 hospital discharges for delivery were studied. The rates of preeclampsia ranged from 2.0% for Chinese to 4.6% for Filipinos. Preeclampsia rates were higher among Native Hawaiians who are age <35 and non-obese (OR 1.54; 95% CI 1.43-1.66), age ≥35 and non-obese (OR 2.31; 95% CI 2.00-2.68), age ≥35 and obese (OR 1.80; 95% CI 1.24-2.60); other Pacific Islanders who are age <35 and non-obese (OR 1.40; 95% CI 1.27-1.54), age ≥35 and non-obese (OR 2.18; 95% CI 1.79-2.64), age ≥35 and obese (OR 1.68; 95% CI 1.14-2.49); and Filipinos who are age <35 and non-obese (OR 1.55; 95% CI 1.43-1.67), age ≥35 and non-obese (OR 2.26; 95% CI 1.97-2.60), age ≥35 and obese (OR 1.64; 95% CI 1.04-2.59) compared to whites. Pregestational diabetes (OR 3.41; 95% CI 3.02-3.85), chronic hypertension (OR 5.98; 95% CI 4.98-7.18), and smoking (OR 1.19; 95% CI 1.07-1.33) were also independently associated with preeclampsia. Conclusions for Practice In Hawaii, Native Hawaiians, other Pacific Islanders and Filipinos have a higher risk of preeclampsia compared to whites. For these high-risk ethnic groups, more frequent monitoring for preeclampsia may be needed.