title: A prospective study of maternal carboxyhaemoglobin and pre-eclampsia risk.
abstract: We aimed to measure the relationship between early-pregnancy maternal carboxyhaemoglobin and subsequent pre-eclampsia risk. A nested case-control analysis was conducted using data from a western Washington State cohort study (1996-2004). We measured maternal whole blood carboxyhaemoglobin in 128 women who developed pre-eclampsia and 419 normotensive controls (mean gestational age at blood draw, 14.8 weeks). After adjustment for confounders, high (>/=1%) vs. low (<0.7%) carboxyhaemoglobin odds ratios [OR] and 95% confidence intervals [CI] were 4.09 [1.30, 12.9] in multiparous women, 0.53 [0.23, 1.26] in primiparae and 1.11 [0.55, 2.25] in the overall study population (parity interaction P = 0.01). The influence of parity on the association was unexpected. The association between high carboxyhaemoglobin and pre-eclampsia risk in multiparae implicates hypoxia at the fetal-maternal interface as a pathogenic mechanism. These results also suggest that the aetiology of the disease may differ according to parity.
authors.affiliation: Department of Social and Preventive Medicine, School of Public Health and Health Professions, University at Buffalo, The State University of New York, Buffalo, NY 14214-8001, USA. cbrudra@buffalo.edu
authors.forename: Carole B
authors.initials: CB
authors.lastname: Rudra
authors.forename: Michelle A
authors.initials: MA
authors.lastname: Williams
authors.forename: Melissa A
authors.initials: MA
authors.lastname: Schiff
authors.forename: Jane Q
authors.initials: JQ
authors.lastname: Koenig
authors.forename: Russell
authors.initials: R
authors.lastname: Dills
authors.forename: Jianbo
authors.initials: J
authors.lastname: Yu
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000378:metabolism; D002263:Carboxyhemoglobin / Q000032:analysis*; D016022:Case-Control Studies; D015331:Cohort Studies; D005260:Female; D006801:Humans; D016015:Logistic Models; D010298:Parity; D011225:Pre-Eclampsia / Q000097:blood* / Q000175:diagnosis; D011247:Pregnancy; D011446:Prospective Studies; D012307:Risk Factors; D055815:Young Adult
chemical_list: D015415:Biomarkers; D002263:Carboxyhemoglobin