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Preeclampsia Presentation Depends On Race, Ethnicity


 

RENO, NEV. — A retrospective study examining 473 pregnancies complicated by preeclampsia has uncovered several significant racial and ethnic differences in the expression of the disorder.

African American women with preeclampsia tend to have more severe hypertension and more often require antihypertensive medication than the population at large, according to a poster presentation by Amy Goodwin, M.D., of Case Western Reserve University, Cleveland, and her associates at the annual meeting of the Society for Maternal-Fetal Medicine.

While 37% of the full sample had severe hypertension at diagnosis, 45% of African American women had severe hypertension.

African American women were also significantly more likely to require antihypertensive medication intrapartum (12% vs. 8.8%), postpartum (18% vs. 13%), and at discharge (35% vs. 27%).

Non-Hispanic white women more frequently manifest severe hypertension with hemolysis, elevated liver enzymes, and low platelet count (HELLP) syndrome. While 24% of the full sample exhibited HELLP, the rate among white women was 30%.

Hispanic women tend to present with preeclampsia later in gestation and with less severe disease than the rest of the population. They presented at a mean of 36 weeks of gestation vs. 34.4 weeks for the rest of the population, and a smaller proportion of them exhibited severe hypertension at diagnosis (27% vs. 37%).

The study found no significant differences by race or ethnicity in a number of other factors including proteinuria, eclampsia, intrauterine fetal distress, intrauterine growth retardation, abruption, and recurrent preeclampsia, they said.

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