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Genetically Estimated Ancestry and the Risk of Pre-Eclampsia: A Multiethnic Case-Control Study.

Frances Conti-Ramsden1, Kypros Nicolaides2, Argyro Syngelaki2

  • 1Department of Women and Children's Health, School of Life Course & Population Sciences, King's College London, London, United Kingdom.

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|November 3, 2025
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Summary

Maternal self-reported ethnicity imperfectly reflects genetic ancestry, which is linked to pre-eclampsia (PE) risk. While West African ancestry independently associates with PE, it did not improve clinical prediction models.

Keywords:
ethnicityhypertensionpre-eclampsiapregnancy

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Area of Science:

  • Genetics
  • Obstetrics
  • Epidemiology

Background:

  • Maternal self-reported ethnicity (SRE) is a known factor in pre-eclampsia (PE) risk prediction.
  • Existing PE prediction models incorporate SRE, but its accuracy in diverse populations is questioned.

Purpose of the Study:

  • To investigate the association between genetic ancestry estimates and PE risk.
  • To determine if genetic ancestry improves the performance of the Fetal Medicine Foundation (FMF) PE risk model.

Main Methods:

  • A case-control study genotyped 5,207 women (PE cases and controls).
  • Genetic ancestry was estimated using a multiethnic reference panel.
  • Logistic regression models incorporated African genetic ancestries alongside clinical risk factors; FMF model performance was compared with and without ancestry data.

Main Results:

  • Significant discrepancies were found between self-reported ethnicity and genetic ancestry.
  • Higher West African ancestry was independently associated with increased PE odds.
  • Incorporating genetic ancestry did not enhance the FMF PE risk model's predictive performance.

Conclusions:

  • Self-reported ethnicity is an imperfect proxy for genetic ancestry in multiethnic cohorts.
  • West African ancestry shows a biological association with PE risk.
  • Genetic ancestry did not improve the gold-standard clinical PE prediction model, highlighting the need for large genomic studies in diverse populations.