Associations of Personal and Family Preeclampsia History With the Risk of Early-, Intermediate- and Late-Onset Preeclampsia

• Published in: American journal of epidemiology 2013-12, Vol.178 (11), p.1611-1619
• Main Authors: Boyd, Heather A., Tahir, Hassaan, Wohlfahrt, Jan, Melbye, Mads
• Format: Article
• Language: English
• Subjects: Adult; Biological and medical sciences; Cohort Studies; Databases, Factual; Denmark - epidemiology; Diseases of mother, fetus and pregnancy; Environmental factors; Epidemiology; Family; Female; Gene-Environment Interaction; General aspects; Genetic disorders; Genetic Predisposition to Disease; Gynecology. Andrology. Obstetrics; Humans; Hypertension; Maternal & child health; Medical History Taking; Medical sciences; Miscellaneous; Odds Ratio; Pre-Eclampsia - diagnosis; Pre-Eclampsia - epidemiology; Pre-Eclampsia - etiology; Preeclampsia; Pregnancy; Pregnancy. Fetus. Placenta; Public health. Hygiene; Public health. Hygiene-occupational medicine; Recurrence; Registries; Regression Analysis; Risk Factors; Severity of Illness Index
• ISSN: 0002-9262; 1476-6256
• DOI: 10.1093/aje/kwt189

Abstract Preeclampsia encompasses multiple conditions of varying severity. We examined the recurrence and familial aggregation of preeclampsia by timing of onset, which is a marker for severity. We ascertained personal and family histories of preeclampsia for women who delivered live singletons in Denmark in 1978–2008 (almost 1.4 million pregnancies). Using log-linear binomial regression, we estimated risk ratios for the associations between personal and family histories of preeclampsia and the risk of early-onset (before 34 weeks of gestation, which is typically the most severe), intermediate-onset (at 34–36 weeks of gestation), and late-onset (after 36 weeks of gestation) preeclampsia. Previous early-, intermediate-, or late-onset preeclampsia increased the risk of recurrent preeclampsia with the same timing of onset 25.2 times (95% confidence interval (CI): 21.8, 29.1), 19.7 times (95% CI: 17.0, 22.8), and 10.3 times (95% CI: 9.85, 10.9), respectively, compared with having no such history. Preeclampsia in a woman's family was associated with a 24%–163% increase in preeclampsia risk, with the strongest associations for early- and intermediate-onset preeclampsia in female relatives. Preeclampsia in the man's family did not affect a woman's risk of early-onset preeclampsia and was only weakly associated with her risks of intermediate- and late-onset preeclampsia. Early-onset preeclampsia appears to have the largest genetic component, whereas environmental factors likely contribute most to late-onset preeclampsia. The role of paternal genes in the etiology of preeclampsia appears to be limited.