Preeclampsia risk factors in French Guiana: a great heterogeneity among populations and geographic areas.

Abstract

Background: French Guiana is France's largest overseas territory, accounting for 1/6th of mainland France. French Guiana has the highest fertility rate in France and Latin America. However, infant mortality, especially neonatal mortality, remains 2.6 times higher than in mainland France. Preeclampsia was found to be the most important pregnancy-related condition contributing to preterm birth in the primary analysis of risk factors for preterm birth in French Guiana.

Methods: Therefore, by analyzing the Registre des Issues de Grossesse de Guyane (RIGI), we sought to better describe this condition and understand its risk factors in our area. A retrospective and comparative study was conducted using 2014-2020 data from the RIGI, which describes 53,522 viable births (≥22 weeks of amenorrhea) in all four perinatal facilities in French Guiana. The RIGI is performed by midwives after patients' delivery. It records data up to two hours postpartum.

Results: During the study 12.9% of children were born preterm at less than 37 WA (weeks of amenorrhea). 4.5% of the study population had preeclampsia, of which almost half, 49.5%, were expected to deliver prematurely. The Afro-Caribbean population has a higher risk of preeclampsia than the white population, more than double that of the caucasians. Despite adjustment for place of birth, there are spatial heterogeneities in preeclampsia, with an increased risk for residents of towns in western French Guiana.

Conclusion: In conclusion, preeclampsia is a major cause of preterm birth and morbidity in French Guiana. The great heterogeneity between populations and geographical areas requires specific blood tests such as angiogenic balance or still heavy metal assays.