Racial Disparities in Comorbidities, Complications, and Maternal and Fetal Outcomes in Women With Preeclampsia/eclampsia.
Racial Disparities in Comorbidities, Complications, and Maternal and Fetal Outcomes in Women With Preeclampsia/eclampsia.
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DOI：
10.3109/10641955.2015.1090581
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发表时间：
2015-11
影响因子：
1.5
通讯作者：
Rana S
中科院分区：
文献类型：
--
作者：
Shahul S;Tung A;Minhaj M;Nizamuddin J;Wenger J;Mahmood E;Mueller A;Shaefi S;Scavone B;Kociol RD;Talmor D;Rana S
导致非洲裔美国人（AA）先兆子痫/子痫妇女结局更差的机制尚不清楚。我们的目的是确定母亲合并症、围产期特征和母亲及胎儿结局的种族差异。与患有先兆子痫/子痫的白色女性相比，AA女性的住院孕产妇死亡率的未校正风险增加（OR 3.70，95% CI：2.19-6.24）。调整协变量后，AA女性的住院死亡率仍高于白色女性（OR 2.85，95%CI：1.38-5.53），而西班牙裔女性的调整后死亡风险与白色女性无差异。我们还发现AA妇女宫内胎儿死亡（IUFD）的风险增加。与患有先兆子痫的白色女性相比，AA女性的IUFD未校正几率增加（OR 2.78，95% CI：2.49-3.11），在校正协变量后仍具有显著性（校正OR 2.45，95% CI：2.14-2.82）。相比之下，在调整协变量后，西班牙裔妇女的IUFD与白色妇女没有差异。我们的数据表明，非洲裔美国妇女更有可能有先兆子痫的危险因素，更有可能遭受围产期护理的不良后果。未来的研究应该检查控制合并症和其他风险因素是否有助于减轻这一队列妇女结局的种族差异。
The mechanisms leading to worse outcomes in African-American (AA) women with preeclampsia/eclampsia remain unclear. Our objective was to identify racial differences in maternal comorbidities, peripartum characteristics, and maternal and fetal outcomes. When compared to white women with preeclampsia/eclampsia, AA women had an increased unadjusted risk of inpatient maternal mortality (OR 3.70, 95% CI: 2.19-6.24). After adjustment for covariates, in-hospital mortality for AA women remained higher than that for white women (OR 2.85, 95% CI: 1.38-5.53), while, the adjusted risk of death among Hispanic women did not differ from that for white women. We also found an increased risk of intrauterine fetal death (IUFD) among AA women. When compared to white women with preeclampsia, AA women had an increased unadjusted odds of IUFD (OR 2.78, 95% CI: 2.49-3.11), which remained significant after adjustment for covariates (adjusted OR 2.45, 95% CI: 2.14-2.82). In contrast, IUFD among Hispanic women did not differ from that for white women after adjusting for covariates. Our data suggest that African American women are more likely to have risk factors for preeclampsia and more likely to suffer an adverse outcome during peripartum care. Future research should examine whether controlling co-morbidities and other risk factors will help to alleviate racial disparities in outcomes in this cohort of women.