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Influence of ethnicity on the clinical and biologic expression of pre-eclampsia in the ECLAXIR study
Authors:Olivia Anselem  Guillaume Girard  Alain Stepanian  Elie Azria  Laurent Mandelbrot
Affiliation:aMaternité Port-Royal, Groupe Hospitalier Cochin Broca Hôtel-Dieu, Assistance Publique-Hôpitaux de Paris, Paris, France;bFaculté de Médecine René Descartes, Université Paris Descartes, Sorbonne Paris Cité, Paris, France;cService de Gynécologie Obstétrique, Hôpital Louis Mourier, Assistance Publique-Hôpitaux de Paris, Colombes, France;dUniversité Paris Denis Diderot, Paris, France;eService d'Hématologie Biologique et transfusion, AP-HP, Hôpital Louis Mourier, Assistance Publique-Hôpitaux de Paris, Colombes, France;fINSERM U.770, Hôpital de Bicêtre, Le Kremlin-Bicêtre, France;gService de Gynécologie Obstétrique, Hôpital Bichat Claude Bernard, Assistance Publique-Hôpitaux de Paris, Paris, France
Abstract:

Objective

To determine whether ethnic origin is related to the clinical and biologic expression of pre-eclampsia.

Methods

In a secondary analysis of information collected in the ECLAXIR study in France between May 2003 and October 2006, the data from 284 white European, 84 Maghrebian and 158 African women were evaluated in a case–control study of the genetic and endothelial determinants of pre-eclampsia.

Results

African origin was a risk factor for pre-eclampsia before 28 weeks of gestation. Symptoms related to hypertension, such as neurologic signs and changes in biologic parameters (e.g. hemolysis elevated liver enzymes, low platelet count [HELLP] syndrome), occurred more frequently among white European women. After logistic regression, gestational age at delivery was lower for African women than for white European women (33.4 weeks versus 34.4 weeks of gestation, P = 0.04).

Conclusion

The results suggest that ethnic origin may have a role in the expression of pre-eclampsia, and should therefore be taken into account in prenatal surveillance. Further research on the genetic factors involved in endothelial dysfunction is warranted.
Keywords:Ethnicity   HELLP syndrome   Hypertension   Intrauterine growth restriction   Pre-eclampsia
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