title: Prevalence of pregnancy hypertensive disorders in Mongolia.
abstract: OBJECTIVE
  To estimate the prevalence of preeclampsia in a contemporary population of Mongolian women living in urban and rural areas. We determined the sensitivity and specificity of diagnosis based on established diagnostic criteria and assessed whether local diagnostic criteria were similar to those used in the US.
  
  
  METHODS
  Cross-sectional study of urban and nomadic pregnant women recruited in Ulaanbaatar (n=136) and rural provinces (n=85).
  
  
  METHODS
  Preeclampsia defined as hypertension new to pregnancy after 20weeks and proteinuria (or protein creatinine ratio ⩾0.3 and dipstick reading>+1) or in the absence of proteinuria, hypertension and onset of: renal insufficiency, impaired liver function, thrombocytopenia, pulmonary edema, cerebral/visual symptoms. Prevalence of preeclampsia based on established criteria was compared with prevalence based on local physician's diagnosis.
  
  
  RESULTS
  Prevalence of local physician diagnosed preeclampsia was 9.5% (13.2% urban, 3.5% rural). Prevalence based on established diagnostic criteria was 4.1% (4.4% urban, 3.5% rural). Sensitivity of physician's diagnosis was 23.8%, specificity was 98.0%, false negative rate was 2.0% and false positive rate was 76.2%. While prevalence based on local physician's diagnosis was over double that based on diagnostic criteria, overdiagnosis did not result in adverse effects. Women fulfilling diagnostic criteria for preeclampsia had babies with higher birth weights than women who did not (p-value=0.006).
  
  
  CONCLUSIONS
  The 4.1% prevalence of preeclampsia in Mongolia was consistent with global estimates of 2-8%, suggesting the pathophysiology of preeclampsia here may be similar to that found globally. Sensitivity of physician's diagnosis was low, specificity was high.
authors.affiliation: Department of Nutrition, Harvard T.H. Chan School of Public Health, 677 Huntington Blvd., Boston, MA 02115, United States. Electronic address: nmarchand@mail.harvard.edu.
authors.forename: Nathalie E
authors.initials: NE
authors.lastname: Marchand
authors.affiliation: Department of Nutrition, Harvard T.H. Chan School of Public Health, 677 Huntington Blvd., Boston, MA 02115, United States; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, 181 Longwood Avenue, Boston, MA 02115, United States. Electronic address: gdavaasa@hsph.harvard.edu.
authors.forename: Ganmaa
authors.initials: G
authors.lastname: Davaasambuu
authors.affiliation: Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA 02115, United States. Electronic address: tmcelrath@partners.org.
authors.forename: Thomas F
authors.initials: TF
authors.lastname: McElrath
authors.affiliation: National Center for Maternal and Child Health, Khuvisgalchdin Street, Bayangol District, Ulaanbaatar, Mongolia. Electronic address: enkhee.khar@yahoo.com.
authors.forename: Enkhmaa
authors.initials: E
authors.lastname: Davaasambuu
authors.affiliation: National Center for Maternal and Child Health, Khuvisgalchdin Street, Bayangol District, Ulaanbaatar, Mongolia. Electronic address: tsedmaabaatar@gmail.com.
authors.forename: Tsedmaa
authors.initials: T
authors.lastname: Baatar
authors.affiliation: Divisions of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, 9609 Medical Center Drive, Rockville, MD 20850, United States. Electronic address: troisir@mail.nih.gov.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Troisi
mesh_terms: D001724:Birth Weight; D002983:Clinical Competence; D003430:Cross-Sectional Studies; D005188:False Negative Reactions; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D008297:Male; D008986:Mongolia / Q000453:epidemiology; D010820:Physicians / Q000592:standards; D017410:Practice Guidelines as Topic; D011225:Pre-Eclampsia / Q000175:diagnosis* / Q000453:epidemiology*; D011247:Pregnancy; D015995:Prevalence; D012424:Rural Population / Q000706:statistics & numerical data*; D012680:Sensitivity and Specificity; D014505:Urban Population / Q000706:statistics & numerical data*
keywords: Monglia; Preeclampsia