title: Preterm preeclampsia in relation to country of birth.
abstract: To examine the association between maternal country of birth and the risk of preeclampsia+preterm birth (PTB).
  
  
  
  We completed a population-based study in the entire province of Ontario, where there is universal access to obstetrical care. We included 881 700 singleton livebirths among Canadian-born mothers and 305 547 births among immigrant mothers. Adjusted risk ratios (aRRs) were adjusted for maternal age, parity and income quintile.
  
  
  
  Compared with a rate of preeclampsia+PTB of 4.0 per 1000 among Canadian-born mothers, the aRR of preeclampsia+PTB at 24 to 36 weeks was significantly higher for immigrant women from Nigeria (1.79, 95% confidence interval (CI) 1.12 to 2.84), the Philippines (1.54, 95% CI 1.30 to 1.86), Colombia (1.68, 95% CI 1.04 to 2.73), Jamaica (2.06, 95% CI 1.66 to 2.57) and Ghana (2.12, 95% CI 1.40 to 3.21). The aRRs generally followed a similar pattern for secondary outcomes. Specifically, women from Ghana were at highest risk of preeclampsia+very PTB (4.55, 95% CI 2.57 to 8.06), and women from Jamaica at the highest risk of preeclampsia+indicated PTB (1.89, 95% CI 1.43 to 2.50).
  
  
  
  The risk of preeclampsia+PTB is highest among women from a select number of countries. This information can enhance initiatives aimed at reducing the risk of PTB related to preeclampsia.
authors.affiliation: Keenan Research Centre, Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, ON, Canada.|University of Toronto, Toronto, ON, Canada.|Institute for Clinical Evaluative Sciences, Toronto, ON, Canada.|Department of Obstetrics and Gynaecology, St Michael's Hospital, Toronto, ON, Canada.
authors.forename: J G
authors.initials: JG
authors.lastname: Ray
authors.affiliation: Keenan Research Centre, Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, ON, Canada.|University of Toronto, Toronto, ON, Canada.
authors.forename: S
authors.initials: S
authors.lastname: Wanigaratne
authors.affiliation: Keenan Research Centre, Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, ON, Canada.|Institute for Clinical Evaluative Sciences, Toronto, ON, Canada.
authors.forename: A L
authors.initials: AL
authors.lastname: Park
authors.affiliation: University of Toronto, Toronto, ON, Canada.
authors.forename: E
authors.initials: E
authors.lastname: Bartsch
authors.affiliation: Maternal and Infant Health Section, Public Health Agency of Canada, Ottawa, ON, Canada.
authors.forename: S
authors.initials: S
authors.lastname: Dzakpasu
authors.affiliation: Keenan Research Centre, Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, ON, Canada.|University of Toronto, Toronto, ON, Canada.|Institute for Clinical Evaluative Sciences, Toronto, ON, Canada.
authors.forename: M L
authors.initials: ML
authors.lastname: Urquia
mesh_terms: D000328:Adult; D054242:Emigrants and Immigrants / Q000706:statistics & numerical data*; D005260:Female; D005869:Ghana / Q000208:ethnology; D006801:Humans; D008423:Maternal Age; D016017:Odds Ratio; D009864:Ontario / Q000453:epidemiology; D010298:Parity; D011225:Pre-Eclampsia / Q000208:ethnology*; D011247:Pregnancy; D047928:Premature Birth / Q000208:ethnology*; D012044:Regression Analysis; D012189:Retrospective Studies; D012959:Socioeconomic Factors; D055815:Young Adult