Detection and risk factors for preeclampsia.
dc.contributor.author | Ceron-Mireles, Prudencia | |
dc.contributor.advisor | Harlow, Sioban D. | |
dc.date.accessioned | 2016-08-30T15:59:48Z | |
dc.date.available | 2016-08-30T15:59:48Z | |
dc.date.issued | 2006 | |
dc.identifier.uri | http://gateway.proquest.com/openurl?url_ver=Z39.88-2004&rft_val_fmt=info:ofi/fmt:kev:mtx:dissertation&res_dat=xri:pqm&rft_dat=xri:pqdiss:3208431 | |
dc.identifier.uri | https://hdl.handle.net/2027.42/125625 | |
dc.description.abstract | Throughout the world, preeclampsia is a leading cause of maternal mortality. In Mexico, it accounts for almost a third of maternal deaths. Research on epidemiology of preeclampsia is difficult because of differences in definition and inaccuracy in diagnosis. Several classification systems for hypertensive disorders of pregnancy have been proposed, however, evaluation of them is lacking. This dissertation aimed to estimate the prevalence of hypertensive disorders of pregnancy, to evaluate two main classification systems of hypertensive disorders of pregnancy proposed by the National High Blood Pressure Education Program (NHBPEP) and the Australasian Society for the Study of Hypertension in Pregnancy (ASSHP) with respect to maternal and fetal outcomes, and to compare both systems with clinical diagnoses. We then evaluated the association between a potential modifiable risk factor, physical activity, and hypertensive disorders of pregnancy. Finally, we identified socioeconomic factors associated with a particularly high risk. A cross-sectional study was conducted in among 3299 uninsured women delivering at the Hospital Infantil of Sonora, Mexico from September 2003 to March 2004. The ASSHP detected 15% more preeclamptic women than the NHBPEP (5.1% and 4.5% respectively). Both classification systems stratified women by probability of adverse maternal and fetal outcomes. Sensitivity of clinical diagnosis for preeclampsia, chronic hypertension and preeclampsia superimposed upon chronic hypertension was low (56.3%, 5.6% and 9.1% respectively). Increasing time spent in household activities was associated with decreasing risk of preeclampsia, (aOR=0.40, 95% CI: 0.20, 0.81 for more than 15 weekly hours). Women expending more than 17.5 METs per week in moderate activities also had a decreased risk for preeclampsia (aOR=0.44, 95% CI; 0.23, 0.85). Socially disadvantaged primiparous women had increased risk for preeclampsia, primiparas having low income (aOR=4.08, 95% CI; 2.24, 7.45), compared with women having high income and parity 2 or 3. Women with low income had also and increased risk to experience chronic hypertension (aOR=1.83, 95% CI; 1.02, 3.28). In conclusion, to reduce the mortality associated with preeclampsia, unifying medical criteria for preeclampsia diagnosis is required, while promotion of moderate physical activity and targeted public health interventions in high-risk primiparous women is needed. | |
dc.format.extent | 127 p. | |
dc.language | English | |
dc.language.iso | EN | |
dc.subject | Detection | |
dc.subject | Hypertension | |
dc.subject | Preeclampsia | |
dc.subject | Pregnancy | |
dc.subject | Risk Factors | |
dc.subject | Toxemia | |
dc.title | Detection and risk factors for preeclampsia. | |
dc.type | Thesis | |
dc.description.thesisdegreename | PhD | en_US |
dc.description.thesisdegreediscipline | Health and Environmental Sciences | |
dc.description.thesisdegreediscipline | Obstetrics | |
dc.description.thesisdegreediscipline | Public health | |
dc.description.thesisdegreegrantor | University of Michigan, Horace H. Rackham School of Graduate Studies | |
dc.description.bitstreamurl | http://deepblue.lib.umich.edu/bitstream/2027.42/125625/2/3208431.pdf | |
dc.owningcollname | Dissertations and Theses (Ph.D. and Master's) |
Files in this item
Remediation of Harmful Language
The University of Michigan Library aims to describe library materials in a way that respects the people and communities who create, use, and are represented in our collections. Report harmful or offensive language in catalog records, finding aids, or elsewhere in our collections anonymously through our metadata feedback form. More information at Remediation of Harmful Language.
Accessibility
If you are unable to use this file in its current format, please select the Contact Us link and we can modify it to make it more accessible to you.