A multivariate analysis of risk factors for preeclampsia.
OBJECTIVE
--To determine, in a multivariate analysis, risk factors for preeclampsia that could be observed early in pregnancy and to establish whether these risk factors are different for nulliparas and multiparas.


METHODS
--A case-control study of preeclampsia.


METHODS
--Women who gave birth at Northern California Kaiser Permanente Medical Centers in 1984 and 1985.


METHODS
--Preeclamptic cases (n = 139) were determined from discharge diagnosis of severe preeclampsia and by confirmation of blood pressures and proteinuria from medical records. Controls (n = 132) were randomly selected women who had no discharge diagnosis of any hypertensive disorder of pregnancy and who had no evidence of hypertension or proteinuria from medical record review.


METHODS
--Medical records were abstracted for information regarding maternal age, race, previous pregnancy history, family medical history, socioeconomic status, employment during pregnancy, body mass, and smoking and alcohol consumption.


RESULTS
--Multiple logistic regression analyses confirmed that case patients were more likely than control patients to be nulliparous (adjusted odds ratio [OR], 5.4; 95% confidence interval [Cl], 2.8 to 10.3) and that preeclampsia in a previous pregnancy greatly increased the risk in a subsequent one (adjusted OR, 10.8; 95% Cl, 1.2 to 29.1). However, regardless of parity, preeclamptic women were also more likely to be of high body mass (adjusted OR, 1.7; 95% Cl, 1.2 to 6.2), to work during pregnancy (adjusted OR, 2.1; 95% Cl, 1.1 to 4.4), and to have a family history of hypertension (adjusted OR, 1.7; 95% Cl, 0.92 to 3.2). Having a previous history of a spontaneous abortion was protective but only in multiparous women (adjusted OR for multiparas, 0.09; 95% Cl, 0.02 to 0.48). In contrast, being black was a significant risk for preeclampsia but only in nulliparous women (adjusted OR for nulliparas, 12.3; 95% Cl, 1.6 to 100.8).


CONCLUSIONS
--There are a number of risk factors for preeclampsia that may be determined early in a woman's pregnancy. Multiparas and nulliparas share certain risk factors but not others. A cohort investigation is needed to determine the ability of these risk factors to predict who develops preeclampsia.
Eskenazi
B
B
Program of Maternal and Child Health, School of Public Health, University of California, Berkeley 94720.
Fenster
L
L
Sidney
S
S
D000328:Adult; D002140:California / Q000453:epidemiology; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D015999:Multivariate Analysis; D010298:Parity; D011225:Pre-Eclampsia / Q000453:epidemiology* / Q000209:etiology; D011247:Pregnancy; D011897:Random Allocation; D012307:Risk Factors; D012959:Socioeconomic Factors