摘要
There is considerable variation in the expression of severe preeclampsia. Our purpose was to determine if this is associated with maternal race or ethnicity. Study design: Individual chart review was performed for women diagnosed with severe preeclampsia at a tertiary care center from 1993 to 2003. Demographic, clinical, and lab findings from diagnosis (Dx) to 6 weeks’ postpartum (PP) were documented. Data were compared between Caucasian, African American, and Hispanic women. Data were presented for the total cohort if no significant difference was found. Results: We evaluated 473 pregnancies: 201 (Caucasian), 216 (African American), and 56 (Hispanic). Groups had similar baseline characteristics: chronic hypertension (HTN), diabetes, and initial antenatal blood pressure (mean BP 118/68). Caucasian women were older (27 vs 24 yrs), more likely nulliparous (63 vs 49% ), and had more multiple gestations (9 vs 1.5% ), P < .002 for each. African Americans had less epigastric pain (7.4 vs 10% ) and nausea (2.3 vs 5% ), P < .05 for each. Platelets < 100,000/μ L and asparate aminotransferase >60 mg/dL were more common in Caucasian women at Dx (9 vs 12% , 11 vs 21% ) and at delivery (14 vs 24% , 19 vs 34% ), P < .05 for each. No difference in severe proteinuria was seen. African Americans had more severe HTN at both Dx (44.9 vs 30% ) and peak BP (85 vs 67% ), and required more antihypertensive Rx intrapartum (12 vs 6% ), PP (38 vs 12% ), and at discharge (35 vs 21% ), P < .03 for each. Hispanics presented later (36 vs 34.6 weeks) and had less severe HTN (27 vs 40% ), P < .04 for each. BP on DC was not different between groups. Caucasian women had more hemolysis, elevated liver enzymes and low platelets syndrome (29 vs 19% , P = .01). Eclampsia, intrauterine fetal demise, intrauterine growth restriction, abruption, PP preeclampsia, and recurrent preeclampsia were similar between groups. Conclusion: African American women with severe preeclampsia demonstrate more severe hypertension and required more antihypertensive Rx, while Caucasian women have more frequent hemolysis, elevated liver enzymes and low platelets syndrome.
Objective: There is considerable variation in the expression of severe preeclampsia. Our purpose was to determine if this is associated with maternal race or cthnicity. Study design: Individual chart review was performed for women diagnosed with severe preeclampsia at a tertiary care center from 1993 to 2003. Demographic, clinical, and lab findings from diagnosis (Dx) to 6 weeks' postpartum (PP) were documented. Data were compared between Caucasian, African American, and Hispanic women. Data were presented for the total cohort if no significant difference was found. Results: We evaluated 473 pregnancies: 201 (Caucasian), 216 (African American), and 56 (Hispanic) . Groups had similar baseline characteristics: chronic hypertension (HTN), diabetes, and initial antenatal blood pressure (mean BP 118/68) Caucasian women were older (27 vs 24 yrs), more likely nulliparous (63 vs 49% ), and had more multiple gestations (9 vs 1.5% ), P 〈 . 002 for each. African Americans had less epigastric pain (7.4 vs 10% ) and nausea (2.3 vs 5% ), P 〈 . 05 for each. Platelets 〈 100, 000/μL and asparate aminotransferase 〉 60 mg/dL were more common in Caucasian women at Dx (9 vs 12%, 11 vs 21%) and at delivery (14vs24%, 19vs34%), P〈.05 for each. No difference in severe proteinuria was seen. African Americans had more severe HTN at both Dx (44. 9 vs 30% ) and peak BP (85 vs 67% ), and required more antihypertensive Rxintrapartum (12vs6%), PP (38vs 12%), and at discharge (35 vs 21% ), P 〈 . 03 for each. Hispanics presented later (36 vs 34. 6 weeks) and had less severe HTN (27 vs 40% ), P 〈. 04 for each.