Assessing the risk of preeclampsia/eclampsia in Mississippi black women with chronic kidney disease using electronic health records

IF 2.9 4区医学 Q2 OBSTETRICS & GYNECOLOGY

Pregnancy Hypertension-An International Journal of Womens Cardiovascular Health Pub Date : 2025-06-13 DOI:10.1016/j.preghy.2025.101224

John S. Clemmer , Kaua A. Campos , Seth T. Lirette , Caroline C. Haley , Tawhida Islam , Eric M. George

{"title":"Assessing the risk of preeclampsia/eclampsia in Mississippi black women with chronic kidney disease using electronic health records","authors":"John S. Clemmer , Kaua A. Campos , Seth T. Lirette , Caroline C. Haley , Tawhida Islam , Eric M. George","doi":"10.1016/j.preghy.2025.101224","DOIUrl":null,"url":null,"abstract":"<div><h3>Objectives</h3><div>Preeclampsia (PE) is risk factor for renal dysfunction, and chronic kidney disease (CKD) is associated with higher prevalence of PE. However, the role of preexisting CKD in PE development in minority mothers has been understudied. Additionally, previous studies rarely examine CKD on PE risk independent from common comorbidities seen in patients with CKD such as hypertension (HTN) and diabetes. Our objective was to determine whether there were disparities in PE risk and overall outcomes in mothers with and without preexisting CKD in white and black mothers from a single-center in Mississippi.</div></div><div><h3>Study design</h3><div>We retrospectively analyzed electronic health records (EHR) from de-identified mothers with known gestation dates (n = 29,451) from the University of Mississippi Medical Center from 2013 to 2022.</div></div><div><h3>Results</h3><div>Black mothers had a significantly increased prevalence of CKD (0.9%) as compared to white mothers (0.6%), which was associated with a higher prevalence of PE (38%) as compared to white CKD mothers (23%). Baseline CKD was also associated with a significantly increased risk of all-cause mortality in blacks but not whites. After controlling for age, medication, baseline HTN, and diabetes, black race (HR 1.7) and CKD (HR 3.2) were major independent risk factors for PE.</div></div><div><h3>Conclusion</h3><div>Although the underlying mechanisms remain unclear, these findings are crucial for improving pre- and post-parturition care for Black CKD pregnant patients to benefit both the fetus and mother. In a rural Mississippi population, our data demonstrates a significant association of pre-existing CKD and incident PE in black patients, suggesting apotential role for renal dysfunction in driving the increased prevalence of PE in this population. Future research aims to investigate genetic factors causing renal and endothelial changes to better understand and address the causes of higher rates of preeclampsia in black women with CKD.</div></div>","PeriodicalId":48697,"journal":{"name":"Pregnancy Hypertension-An International Journal of Womens Cardiovascular Health","volume":"41 ","pages":"Article 101224"},"PeriodicalIF":2.9000,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Pregnancy Hypertension-An International Journal of Womens Cardiovascular Health","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2210778925000406","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"OBSTETRICS & GYNECOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Objectives

Preeclampsia (PE) is risk factor for renal dysfunction, and chronic kidney disease (CKD) is associated with higher prevalence of PE. However, the role of preexisting CKD in PE development in minority mothers has been understudied. Additionally, previous studies rarely examine CKD on PE risk independent from common comorbidities seen in patients with CKD such as hypertension (HTN) and diabetes. Our objective was to determine whether there were disparities in PE risk and overall outcomes in mothers with and without preexisting CKD in white and black mothers from a single-center in Mississippi.

Study design

We retrospectively analyzed electronic health records (EHR) from de-identified mothers with known gestation dates (n = 29,451) from the University of Mississippi Medical Center from 2013 to 2022.

Results

Black mothers had a significantly increased prevalence of CKD (0.9%) as compared to white mothers (0.6%), which was associated with a higher prevalence of PE (38%) as compared to white CKD mothers (23%). Baseline CKD was also associated with a significantly increased risk of all-cause mortality in blacks but not whites. After controlling for age, medication, baseline HTN, and diabetes, black race (HR 1.7) and CKD (HR 3.2) were major independent risk factors for PE.

Conclusion

Although the underlying mechanisms remain unclear, these findings are crucial for improving pre- and post-parturition care for Black CKD pregnant patients to benefit both the fetus and mother. In a rural Mississippi population, our data demonstrates a significant association of pre-existing CKD and incident PE in black patients, suggesting a potential role for renal dysfunction in driving the increased prevalence of PE in this population. Future research aims to investigate genetic factors causing renal and endothelial changes to better understand and address the causes of higher rates of preeclampsia in black women with CKD.

查看原文本刊更多论文

使用电子健康记录评估患有慢性肾脏疾病的密西西比州黑人妇女先兆子痫/子痫的风险

目的子痫前期（PE）是肾功能不全的危险因素，慢性肾脏疾病（CKD）与PE的高患病率相关。然而，先前存在的CKD在少数民族母亲PE发展中的作用尚未得到充分研究。此外，以往的研究很少检查CKD对PE风险独立于常见的CKD合并症，如高血压（HTN）和糖尿病。我们的目的是确定在密西西比州的一个单一中心中，白人和黑人母亲中有和没有先前存在CKD的母亲的PE风险和总体结果是否存在差异。研究设计：我们回顾性分析了2013年至2022年密西西比大学医学中心已知妊娠日期的未识别母亲（n = 29,451）的电子健康记录（EHR）。与白人母亲（0.6%）相比，黑人母亲的CKD患病率显著增加（0.9%），与白人CKD母亲（23%）相比，PE患病率更高（38%）相关。基线CKD也与黑人全因死亡风险显著增加相关，但与白人无关。在控制了年龄、药物、基线HTN和糖尿病后，黑人（HR 1.7）和CKD （HR 3.2）是PE的主要独立危险因素。结论虽然潜在的机制尚不清楚，但这些发现对于改善黑人CKD孕妇的产前和产后护理至关重要，有利于胎儿和母亲。在密西西比州的农村人口中，我们的数据显示黑人患者中预先存在的CKD和PE事件有显著的关联，提示肾功能障碍在推动该人群中PE患病率增加的潜在作用。未来的研究旨在研究导致肾脏和内皮改变的遗传因素，以更好地了解和解决黑人女性CKD先兆子痫发生率较高的原因。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Pregnancy Hypertension-An International Journal of Womens Cardiovascular Health OBSTETRICS & GYNECOLOGYPERIPHERAL VASCULAR-PERIPHERAL VASCULAR DISEASE

CiteScore

4.90

自引率

0.00%

发文量

127

期刊介绍： Pregnancy Hypertension: An International Journal of Women''s Cardiovascular Health aims to stimulate research in the field of hypertension in pregnancy, disseminate the useful results of such research, and advance education in the field. We publish articles pertaining to human and animal blood pressure during gestation, hypertension during gestation including physiology of circulatory control, pathophysiology, methodology, therapy or any other material relevant to the relationship between elevated blood pressure and pregnancy. The subtitle reflects the wider aspects of studying hypertension in pregnancy thus we also publish articles on in utero programming, nutrition, long term effects of hypertension in pregnancy on cardiovascular health and other research that helps our understanding of the etiology or consequences of hypertension in pregnancy. Case reports are not published unless of exceptional/outstanding importance to the field.