MATERNAL RACIAL ORIGIN AND PREECLAMPSIA: COHORT STUDY AND SYSTEMATIC
REVIEW WITH META-ANALYSIS
Abstract
Objectives: To examine the association between racial origin and
preeclampsia(PE) and gestational hypertension(GH) after adjustment for
factors in maternal characteristics and medical history in screening
study from the Fetal Medicine Foundation (FMF) in England, and to
perform a systematic review and meta-analysis of studies on PE. Methods:
In the FMF data regression analysis was performed to examine the
association between racial origin and PE or GH. Literature search to
December 2021 was carried out to identify peer-reviewed publications on
race and PE. Main outcome measure: Relative risk of PE and GH in women
of black, South Asian and East Asian racial origin by comparison to
white women. Results: In the FMF study there were 168,966 singleton
pregnancies without major abnormalities delivering at ≥24 weeks’
gestation. In black women the respective risk of total-PE and preterm-PE
was 2-fold and 2.5-fold higher and risk of GH was 25% higher, in South
Asian women there was a 1.5-fold higher risk of preterm-PE but not
total-PE, and in East Asian women there was no significant difference in
risk of hypertensive disorders. The literature search identified 19
studies that provided data on several million of pregnancies, but 17
were at moderate or high-risk of bias and only three provided risks
adjusted for some maternal characteristics; consequently, these studies
did not provide accurate contribution of different racial groups to the
prediction of PE. Conclusion: In women of black and South Asian origin
the risk of PE, after adjustment for confounders, is higher than in
white women