Variations in Eclampsia Risk Across Asian Origin Groups in the United States

Eclampsia is a leading contributor of severe maternal morbidity in the United States. Although the rates of severe maternal morbidity for Asian and non-Hispanic White birthing people are similar, variations in eclampsia risk across Asian origin groups have not been adequately studied.

A cross-sectional study using public access Natality Files data (2018-2021). The exposure was maternal race (non-Hispanic White or Asian), and nativity (foreign- or US-born), with foreign-born non-Hispanic White birthing people defined as the reference group. The outcome was eclampsia. Adjusted odds ratios (aOR) and 95% confidence intervals (CI) of eclampsia associated with race and nativity were estimated using multivariable logistic regression models.

Of the 8,295,025 birth certificates analyzed, 21,547 (26.0 per 10,000) recorded eclampsia. The incidence of eclampsia per 10,000 was 14.7 for foreign-born White people, 26.7 for US-born White, 20.9 for foreign-born Asians, and 49.6 for US-born Asians. Among Asian origin groups, the highest incidence of eclampsia per 10,000 was observed among US-born Japanese (256.0), followed by US-born Filipinos (120.6), foreign-born Filipinos (82.9) and US-born Japanese (32.7). After adjustment and compared to foreign-born White people, US-born Filipinos had the highest odds of eclampsia (aOR: 9.36; 95% CI: 7.51, 11.67), followed by foreign-born Filipino (aOR: 6.09; 95% CI: 4.95, 7.50), US-born Japanese (aOR: 4.89; 95% CI: 3.45, 6.92), foreign-born Japanese (aOR: 3.18; 95% CI:2.26, 4.47), and US-born non-Hispanic White (aOR: 2.13; 95% CI: 1.96, 2.32).

Eclampsia risk varies significantly across Asian origin groups and by nativity.