Carole B Rudra1, Michelle A Williams. 1. Department of Epidemiology, University of Washington School of Public Health and Community Medicine, Seattle, WA , USA. clb3@u.washington.edu
Abstract
OBJECTIVE: We investigated the extent of monthly variation in preeclampsia prevalence among primiparous women in Washington State who delivered from 1987 through 2001. METHODS: We identified all primiparae who gave birth to a singleton live infant during the study period using state birth records linked to hospital inpatient discharge data. We obtained a random sample and excluded women with pre-existing hypertension, renal disease, or diabetes mellitus or missing information on estimated date of conception (EDC) (n = 79 298). We defined preeclampsia (n = 6680) according to maternal birth hospitalization diagnosis codes and birth records. We calculated adjusted prevalence odds ratios (PR) and 95% confidence intervals (95% CI) of preeclampsia in each month of conception, relative to the month of lowest prevalence. RESULTS: The prevalence of preeclampsia among primiparae was lowest among those conceiving in January (7.7%) and peaked among February, April, and July conceptions (8.9%). After adjustment, prevalence was significantly higher among women conceiving in February and April through August (PRs versus January: 1.14-1.19). CONCLUSIONS: The prevalence of preeclampsia among primiparous women in Washington peaks among those conceiving in spring and summer. Exposures with similar monthly fluctuations may contribute to the etiology of preeclampsia.
OBJECTIVE: We investigated the extent of monthly variation in preeclampsia prevalence among primiparous women in Washington State who delivered from 1987 through 2001. METHODS: We identified all primiparae who gave birth to a singleton live infant during the study period using state birth records linked to hospital inpatient discharge data. We obtained a random sample and excluded women with pre-existing hypertension, renal disease, or diabetes mellitus or missing information on estimated date of conception (EDC) (n = 79 298). We defined preeclampsia (n = 6680) according to maternal birth hospitalization diagnosis codes and birth records. We calculated adjusted prevalence odds ratios (PR) and 95% confidence intervals (95% CI) of preeclampsia in each month of conception, relative to the month of lowest prevalence. RESULTS: The prevalence of preeclampsia among primiparae was lowest among those conceiving in January (7.7%) and peaked among February, April, and July conceptions (8.9%). After adjustment, prevalence was significantly higher among women conceiving in February and April through August (PRs versus January: 1.14-1.19). CONCLUSIONS: The prevalence of preeclampsia among primiparous women in Washington peaks among those conceiving in spring and summer. Exposures with similar monthly fluctuations may contribute to the etiology of preeclampsia.
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