title: Racial/Ethnic Disparities in the Association Between Preeclampsia Risk Factors and Preeclampsia Among Women Residing in Hawaii.
abstract: Objective To assess differences in the rates of preeclampsia among a multiethnic population in Hawaii. Methods We performed a retrospective study on statewide inpatient data for delivery hospitalizations in Hawaii between January 1995 and December 2013. Multivariable logistic regression was used to assess the impact of maternal race/ethnicity on the rates of preeclampsia after adjusting for age, multiple gestation, multiparity, chronic hypertension, pregestational diabetes, obesity and smoking. Results A total of 271,569 hospital discharges for delivery were studied. The rates of preeclampsia ranged from 2.0 % for Chinese to 4.6 % for Filipinos. Preeclampsia rates were higher among Native Hawaiians who are age <35 and non-obese (OR 1.54; 95 % CI 1.43-1.66), age ≥35 and non-obese (OR 2.31; 95 % CI 2.00-2.68), age ≥35 and obese (OR 1.80; 95 % CI 1.24-2.60); other Pacific Islanders who are age <35 and non-obese (OR 1.40; 95 % CI 1.27-1.54), age ≥35 and non-obese (OR 2.18; 95 % CI 1.79-2.64), age ≥35 and obese (OR 1.68; 95 % CI 1.14-2.49); and Filipinos who are age <35 and non-obese (OR 1.55; 95 % CI 1.43-1.67), age ≥35 and non-obese (OR 2.26; 95 % CI 1.97-2.60), age ≥35 and obese (OR 1.64; 95 % CI 1.04-2.59) compared to whites. Pregestational diabetes (OR 3.41; 95 % CI 3.02-3.85), chronic hypertension (OR 5.98; 95 % CI 4.98-7.18), and smoking (OR 1.19; 95 % CI 1.07-1.33) were also independently associated with preeclampsia. Conclusions for Practice In Hawaii, Native Hawaiians, other Pacific Islanders and Filipinos have a higher risk of preeclampsia compared to whites. For these high-risk ethnic groups, more frequent monitoring for preeclampsia may be needed.
authors.affiliation: The Queen's Medical Center, 1301 Punchbowl Street, Honolulu, HI, 96813, USA. kazuma.nakagawa@hawaii.edu.|Department of Medicine, John A. Burns School of Medicine, University of Hawaii, Honolulu, HI, USA. kazuma.nakagawa@hawaii.edu.
authors.forename: Kazuma
authors.initials: K
authors.lastname: Nakagawa
authors.affiliation: Office of Biostatistics and Quantitative Health Sciences, John A. Burns School of Medicine, University of Hawaii, Honolulu, HI, USA.
authors.forename: Eunjung
authors.initials: E
authors.lastname: Lim
authors.affiliation: The Queen's Medical Center, 1301 Punchbowl Street, Honolulu, HI, 96813, USA.|Department of Obstetrics and Gynecology, John A. Burns School of Medicine, University of Hawaii, Honolulu, HI, USA.
authors.forename: Scott
authors.initials: S
authors.lastname: Harvey
authors.affiliation: Hawaii Health Information Corporation, Honolulu, HI, USA.
authors.forename: Jill
authors.initials: J
authors.lastname: Miyamura
authors.affiliation: Daniel K. Inouye College of Pharmacy, University of Hawaii, Hilo, HI, USA.
authors.forename: Deborah T
authors.initials: DT
authors.lastname: Juarez
mesh_terms: D000328:Adult; D044466:Asian People / Q000706:statistics & numerical data*; D005260:Female; D006254:Hawaii / Q000453:epidemiology; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D054525:Minority Health; D044468:Native Hawaiian or Pacific Islander / Q000706:statistics & numerical data*; D011225:Pre-Eclampsia / Q000208:ethnology*; D011247:Pregnancy; D012189:Retrospective Studies; D012307:Risk Factors; D044465:White People / Q000706:statistics & numerical data*; D055815:Young Adult
keywords: Eclampsia; Health care disparities; Minority health; Preeclampsia