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Pre-eclampsia rates in the United States, 1980-2010: age-period-cohort analysis

Objective To estimate the contributions of biological aging, historical trends, and birth cohort effects on trends in pre-eclampsia in the United States. Design Population based retrospective study. Setting National hospital discharge survey datasets, 1980-2010, United States. Participants 120 milli...

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Autores principales: Ananth, Cande V, Keyes, Katherine M, Wapner, Ronald J
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group Ltd. 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3898425/
https://www.ncbi.nlm.nih.gov/pubmed/24201165
http://dx.doi.org/10.1136/bmj.f6564
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author Ananth, Cande V
Keyes, Katherine M
Wapner, Ronald J
author_facet Ananth, Cande V
Keyes, Katherine M
Wapner, Ronald J
author_sort Ananth, Cande V
collection PubMed
description Objective To estimate the contributions of biological aging, historical trends, and birth cohort effects on trends in pre-eclampsia in the United States. Design Population based retrospective study. Setting National hospital discharge survey datasets, 1980-2010, United States. Participants 120 million women admitted to hospital for delivery. Main outcome measures Temporal changes in rates of mild and severe pre-eclampsia in relation to maternal age, year of delivery, and birth cohorts. Poisson regression as well as multilevel age-period-cohort models with adjustment for obesity and smoking were incorporated. Results The rate of pre-eclampsia was 3.4%. The age-period-cohort analysis showed a strong age effect, with women at the extremes of maternal age having the greatest risk of pre-eclampsia. In comparison with women delivering in 1980, those delivering in 2003 were at 6.7-fold (95% confidence interval 5.6-fold to 8.0-fold) increased risk of severe pre-eclampsia. Period effects declined after 2003. Trends for severe pre-eclampsia also showed a modest birth cohort effect, with women born in the 1970s at increased risk. Compared with women born in 1955, the risk ratio for women born in 1970 was 1.2 (95% confidence interval 1.1 to 1.3). Similar patterns were also evident for mild pre-eclampsia, although attenuated. Changes in the population prevalence of obesity and smoking were associated with period and cohort trends in pre-eclampsia but did not explain the trends. Conclusions Rates of severe pre-eclampsia have been increasing in the United States and age-period-cohort effects all contribute to these trends. Although smoking and obesity have driven these trends, changes in the diagnostic criteria may have also contributed to the age-period-cohort effects. Health consequences of rising obesity rates in the United States underscore that efforts to reduce obesity may be beneficial to maternal and perinatal health.
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spelling pubmed-38984252014-02-19 Pre-eclampsia rates in the United States, 1980-2010: age-period-cohort analysis Ananth, Cande V Keyes, Katherine M Wapner, Ronald J BMJ Research Objective To estimate the contributions of biological aging, historical trends, and birth cohort effects on trends in pre-eclampsia in the United States. Design Population based retrospective study. Setting National hospital discharge survey datasets, 1980-2010, United States. Participants 120 million women admitted to hospital for delivery. Main outcome measures Temporal changes in rates of mild and severe pre-eclampsia in relation to maternal age, year of delivery, and birth cohorts. Poisson regression as well as multilevel age-period-cohort models with adjustment for obesity and smoking were incorporated. Results The rate of pre-eclampsia was 3.4%. The age-period-cohort analysis showed a strong age effect, with women at the extremes of maternal age having the greatest risk of pre-eclampsia. In comparison with women delivering in 1980, those delivering in 2003 were at 6.7-fold (95% confidence interval 5.6-fold to 8.0-fold) increased risk of severe pre-eclampsia. Period effects declined after 2003. Trends for severe pre-eclampsia also showed a modest birth cohort effect, with women born in the 1970s at increased risk. Compared with women born in 1955, the risk ratio for women born in 1970 was 1.2 (95% confidence interval 1.1 to 1.3). Similar patterns were also evident for mild pre-eclampsia, although attenuated. Changes in the population prevalence of obesity and smoking were associated with period and cohort trends in pre-eclampsia but did not explain the trends. Conclusions Rates of severe pre-eclampsia have been increasing in the United States and age-period-cohort effects all contribute to these trends. Although smoking and obesity have driven these trends, changes in the diagnostic criteria may have also contributed to the age-period-cohort effects. Health consequences of rising obesity rates in the United States underscore that efforts to reduce obesity may be beneficial to maternal and perinatal health. BMJ Publishing Group Ltd. 2013-11-07 /pmc/articles/PMC3898425/ /pubmed/24201165 http://dx.doi.org/10.1136/bmj.f6564 Text en © Ananth et al 2013 http://creativecommons.org/licenses/by-nc/3.0/ This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 3.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/3.0/.
spellingShingle Research
Ananth, Cande V
Keyes, Katherine M
Wapner, Ronald J
Pre-eclampsia rates in the United States, 1980-2010: age-period-cohort analysis
title Pre-eclampsia rates in the United States, 1980-2010: age-period-cohort analysis
title_full Pre-eclampsia rates in the United States, 1980-2010: age-period-cohort analysis
title_fullStr Pre-eclampsia rates in the United States, 1980-2010: age-period-cohort analysis
title_full_unstemmed Pre-eclampsia rates in the United States, 1980-2010: age-period-cohort analysis
title_short Pre-eclampsia rates in the United States, 1980-2010: age-period-cohort analysis
title_sort pre-eclampsia rates in the united states, 1980-2010: age-period-cohort analysis
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3898425/
https://www.ncbi.nlm.nih.gov/pubmed/24201165
http://dx.doi.org/10.1136/bmj.f6564
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