Effect of Parity on Pregnancy-Associated Hypertension among Asian American Women in the United States 公开

Abstract

BACKGROUND: Asian Americans in the U.S. are a fastest-growing racial group. Despite having a higher socio-economic status, Asian Americans are observed to experience higher rates of maternal morbidity and mortality compared to other races. Pregnancy-associated hypertension (PAH) includes gestational hypertension, preeclampsia and eclampsia. Although a protective effect of multi-parity on PAH has been observed in previous studies, the association is not well-understood among Asian American women in the U.S.

METHODS: Using live births data from 2014 U.S. National Vital Statistics System, we examined whether higher parity reduces the risk of PAH and whether the association is different across Asian ethnic groups among Asian American mothers who had singleton live births (N=235,303). We estimated adjusted odds ratios (aORs) and 95% confidence intervals using multivariable logistic regression analysis.

RESULTS: Overall, 2.7% of Asian American women were recorded to have PAH during pregnancy in the birth certificates. Specifically, 2.8% Asian Indian, 1.4% Chinese, 5.3% Filipino, 2.2% Japanese, 2.3% Korean, 2.2% Vietnamese and 3.0% other Asian ethnics reported having PAH. A significant difference in the number of previous pregnancies was among mothers with and without PAH (P value <.0001). A higher parity was associated with a significant reduction in the risk of PAH, where women who had 1-2 previous pregnancies (aOR: 0.61, 95%CI: 0.58, 0.65) and who had 3 or more previous pregnancies (aOR: 0.62, 95%CI: 0.57, 0.68) compared to nulliparous women, after controlling for potential co-factors.

CONCLUSIONS: Our study shows that nulliparity is significantly associated with a higher risk of PAH among Asian American women; and the risk varies further by different Asian ethnicities. Filipino American has higher risk of PAH than other Asian ethnic subgroups. Future studies should identify specific factors that are driving the disparities between Filipino and other Asian ethnics and compare the effect of parity on PAH between Asian American and other races in the U.S.

Table of Contents

Background……………………….………………………..…………..1 Methods………………...……….……………………………………….8 Results……………………………………………………………………..12 Discussion……..………………………………………………………..15 References………..…………………………………………………….20 Table 1…………………………………………………………………... 27 Table 2…………………………………………………………………... 28 Table 3………….……………………………………………………….. 30 Table 4………….……………………………………………………….. 32

About this Master's Thesis

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School	Rollins School of Public Health
Department	Epidemiology
Degree	MPH
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health Health Sciences, Epidemiology
关键词	Asian American Pregnancy-associated hypertension Parity
Committee Chair / Thesis Advisor	Kancherla, Vijaya , Emory University
Committee Members	Binongo, Jose N, Emory University
Partnering Agencies	CDC

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