Faiz AS, Demissie K, Ananth CV, Rhoads GG; Academy for Health Services Research and Health Policy. Meeting.
Abstr Acad Health Serv Res Health Policy Meet. 2000; 17: UNKNOWN.
Presented by: Ambarina S. Faiz. M.D., Primary Care / Health Services Research Fellow, Department of Family Medicine, University of Medicine and Dentistry of New Jersey, Robert Wood Johnson Medical School. One Robert Wood Johnson Place-CN 19, New Brunswick, New Jersey, 08903-0019. Tel: 732-235-6139 : Fax: 732-246-8654: e-mail: faizas@umdnj.edu.
Research Objective: African-American women residing in Southern regions of US show an increased incidence of chronic hypertension and pregnancy induced hypertension. Chronic hypertension and hypertensive disorders of pregnancy are established risk factors for abruptio placentae. We therefore hypothesized that Southern-born African-American women have higher incidence of abruptio placentae, irrespective of their region of residence. Study Design: It was a retrospective cohort study in which the birth cohort data of 1995 and 1996 derived from national linked birth / infant death data sets were used. These data were assembled by National Center for Health Statistics and were based on 7.6 million births. Abruptio placenta was the primary outcome in this study. On the vital statistics data a diagnosis of placental abruption was recorded if the placenta was partially or completely separated from its site of implantation prior to the delivery of the fetus. For each birth, data on sociodemographic characteristics of mother, including age, race/ethnicity, marital status, education, place of birth and place of residence, as well as smoking habits and alcohol use during pregnancy, were recorded on birth certificates. Obstetric data included medical risk factors, such as hypertensive disorders, anemia, intrapartum fever, and renal diseases. The place of birth of African-American women was grouped into five regions: Northeast, Midwest, West and South and foreign-born and the place of residence was grouped into four regions: Northeast, Midwest, West and South. The four regions of US are based on Census aggregates of states. Age-adjusted and age- and gravidity-adjusted rates of abruption were derived for combinations of regions of birth and regions of residence for all singleton live births among African-American women. Population Studied: All live singleton births among African-American women for the years 1995 and 1996.Principal Findings: Abruptio placentae were recorded in 6.7 per 1000 live births among African-American women in the US. For women who did not migrate the age-adjusted rates of abruption were higher among African-American women of the Northeast (8.3 per 1000), followed by Midwest (6.3 per 1000) and South (6.0 per 1000). African-American women of the West (4.9 per 1000), and foreign-born African-American women (4.0 per 1000) irrespective of their region of residence had lower rates of abruption. Similarly the prevalence of recognized risk factors for abruption were highest among African-American women residing in the Northeast followed by those who resided in the Midwest and South. Conclusion: The results of the study suggest that place of residence rather than place of birth was associated with the risk of placental abruption and the prevalence of risk factors determined the rates of abruption. However, among foreign-born African-American women the risk factors were less common and they had significantly lower risk of abruption irrespective of their region of residence. Implications for Policy, Delivery or Practice: The results of the study can be used to identify women at higher risk of abruption. Early antenatal care and proper management of the risk factors among these women may reduce the incidence of abruption and thus the maternal and perinatal morbidity and mortality.Primary Funding Source: Health Resources and Services Administration; Institutional National Research Service Award, T32 PE10011A; "Primary Care Consortium Research Training Program"; July1, 1998 - June 30, 2003;
Publication Types:
Keywords:
- Abruptio Placentae
- African Americans
- Cohort Studies
- Continental Population Groups
- Female
- Humans
- Hypertension
- Incidence
- Infant
- Live Birth
- Parturition
- Pregnancy
- Pregnancy Complications
- Pregnancy Outcome
- Prenatal Care
- Prevalence
- Residence Characteristics
- Retrospective Studies
- Risk Factors
- United States
- hsrmtgs
Other ID:
UI: 102272097
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