Risk factors for pre-eclampsia in a large cohort of Latin American and Caribbean women.
OBJECTIVE
To study risk factors for pre-eclampsia in a large cohort of Latin American and Caribbean women.


METHODS
Retrospective cross-sectional study from the Perinatal Information System, the database of the Latin American Center for Perinatology and Human Development, Montevideo, Uruguay.


METHODS
Latin America and the Caribbean, 1985-1997. Population 878,680 pregnancies at 700 hospitals; of these 42,530 were complicated by pre-eclampsia and 1,872 by eclampsia.


METHODS
Crude and adjusted relative risks (RR) of risk factors for pre-eclampsia. Adjusted relative risks were obtained after adjustment for potential confounding factors through multiple logistic regression models based on the method of generalised estimating equations.


RESULTS
The following risk factors were significantly associated with increased risk of pre-eclampsia: nulliparity (RR 2 x 38; 95% CI 2 x 28-2 x 49); multiple pregnancy (RR 2 x 10; 95% CI 1 x 90-2 x 32); history of chronic hypertension (RR 1 x 99; 95% CI 1 x 78-2 x 22); gestational diabetes mellitus (RR 1 x 93; 95% CI 1 x 66-2 x 25); maternal age > or = 35 years (RR 1 x 67; 95% CI 1 x 58-1 x 77); fetal malformation (RR 1 x 26; 95% CI 1 x 16-1 x 37); and mother not living with infant's father (RR 1 x 21; 95% CI 1 x 15-1 x 26). Pre-eclampsia risk increased according to pre-pregnancy body mass index (BMI). In comparison with women with a normal pre-pregnancy BMI (19 x 8 to 26 x 0), the RR estimates were 1 x 57 (95% CI 1 x 49-1 x 64) and 2 x 81 95% CI 2 x 69-2 x 94), respectively, for overweight women (pre-pregnancy BMI = 26 x 1 to 29 x 0) and obese women (pre-pregnancy BMI > 29 x 0). Cigarette smoking during pregnancy and a pre-pregnancy BMI < 19 x 8 were significant protective factors against the development of pre-eclampsia. The pattern of risk factors among nulliparous and multiparous women was quite similar.


CONCLUSIONS
Risk factors for pre-eclampsia observed among Latin American and Caribbean women are similar to those found among North American and European women.
Conde-Agudelo
A
A
Latin American Centre for Perinatology and Human Development, Pan American Health Organisation, World Health Organisation, Montevideo, Uruguay.
Belizán
J M
JM
D000293:Adolescent; D000328:Adult; D001827:Body Height; D015992:Body Mass Index; D002648:Child; D015331:Cohort Studies; D004522:Educational Status; D005260:Female; D006801:Humans; D007843:Latin America / Q000453:epidemiology; D017533:Marital Status; D008423:Maternal Age; D011225:Pre-Eclampsia / Q000453:epidemiology / Q000209:etiology*; D011247:Pregnancy; D012189:Retrospective Studies; D012307:Risk Factors