Associations of personal and family preeclampsia history with the risk of early-, intermediate- and late-onset preeclampsia.
Preeclampsia encompasses multiple conditions of varying severity. We examined the recurrence and familial aggregation of preeclampsia by timing of onset, which is a marker for severity. We ascertained personal and family histories of preeclampsia for women who delivered live singletons in Denmark in 1978-2008 (almost 1.4 million pregnancies). Using log-linear binomial regression, we estimated risk ratios for the associations between personal and family histories of preeclampsia and the risk of early-onset (before 34 weeks of gestation, which is typically the most severe), intermediate-onset (at 34-36 weeks of gestation), and late-onset (after 36 weeks of gestation) preeclampsia. Previous early-, intermediate-, or late-onset preeclampsia increased the risk of recurrent preeclampsia with the same timing of onset 25.2 times (95% confidence interval (CI): 21.8, 29.1), 19.7 times (95% CI: 17.0, 22.8), and 10.3 times (95% CI: 9.85, 10.9), respectively, compared with having no such history. Preeclampsia in a woman's family was associated with a 24%-163% increase in preeclampsia risk, with the strongest associations for early- and intermediate-onset preeclampsia in female relatives. Preeclampsia in the man's family did not affect a woman's risk of early-onset preeclampsia and was only weakly associated with her risks of intermediate- and late-onset preeclampsia. Early-onset preeclampsia appears to have the largest genetic component, whereas environmental factors likely contribute most to late-onset preeclampsia. The role of paternal genes in the etiology of preeclampsia appears to be limited.
Heather A
HA
Boyd
Hassaan
H
Tahir
Jan
J
Wohlfahrt
Mads
M
Melbye
D000328:Adult; D015331:Cohort Studies; D016208:Databases, Factual; D003718:Denmark / Q000453:epidemiology; D005190:Family; D005260:Female; D059647:Gene-Environment Interaction; D020022:Genetic Predisposition to Disease; D006801:Humans; D008487:Medical History Taking; D016017:Odds Ratio; D011225:Pre-Eclampsia / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D011247:Pregnancy; D012008:Recurrence; D012042:Registries; D012044:Regression Analysis; D012307:Risk Factors; D012720:Severity of Illness Index
familial aggregation; partner change; preeclampsia; recurrence; timing of onset