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Change in paternity: a risk factor for preeclampsia in multiparas
L S Trupin1, L P Simon, B Eskenazi
1Epidemiology/Biostatistics Program, School of Public Health, University of California, Berkeley 94720, USA.
Epidemiology (Cambridge, Mass.)
|May 1, 1996
Summary
Preeclampsia risk is higher for first-time mothers and multiparas with new partners. However, subsequent pregnancies, even with a new partner, may reduce preeclampsia risk.
Area of Science:
- Reproductive Immunology
- Maternal-Fetal Medicine
- Obstetrics
Background:
- Preeclampsia is a pregnancy hypertensive disorder.
- It's theorized to stem from maternal immune response to paternal antigens.
- Multiparas typically have lower preeclampsia risk than nulliparas due to antigen exposure.
Purpose of the Study:
- To investigate if multiparas with new partners have elevated preeclampsia risk, similar to nulliparas.
- To compare preeclampsia risk between nulliparas, multiparas with new partners, and multiparas with unchanged partners.
Main Methods:
- Retrospective cohort study of 5,068 nulliparas and 5,800 multiparas (1959-1967).
- Analysis included 573 multiparas who changed paternity.
- Preeclampsia and gestational hypertension diagnoses were recorded.
Main Results:
- Preeclampsia incidence: 3.2% (nulliparas), 3.0% (multiparas with new partners), 1.9% (multiparas with no partner change).
- Adjusted odds ratio for preeclampsia: 2.5 (nulliparas) and 1.4 (multiparas with new partners) vs. multiparas with no change.
- Preeclampsia attributable risk associated with paternity change in multiparas was 29%.
Conclusions:
- Findings partially support the immunologic theory of preeclampsia.
- Multiparity, regardless of partner change, is associated with reduced preeclampsia risk.
- Subsequent pregnancies may confer a protective effect against preeclampsia.