Fellus, S.

Socioeconomic determinants of preeclampsia in Alberta
Fellus, S., Ospina, M., Chari, R., Kaul, P.

Preeclampsia is a hypertensive disorder of pregnancy affecting 3-8% of women worldwide, and is classically characterized by elevated blood pressure and end-organ damage. Progression of preeclampsia may lead to devastating effects on both mother and child. The aim of this study is to characterize preeclampsia using a social determinants lens in order to increase and complement our molecular understanding of this disease. The primary objective is to assess the influence of maternal area of residence, socioeconomic status, ethnicity, and immigrant status on the incidence of preeclampsia in Alberta.

This retrospective cohort study will utilize administrative maternal and fetal health data from an Alberta pregnancy and birth cohort between 2005 and 2018. Data will be linked to census data that will be used to determine rural/urban status, and to incorporate neighborhood-level information on maternal socioeconomic status at the time of pregnancy. Maternal ethnicity and immigrant status will be obtained through the use of established naming algorithms for the former and information on the previous country of residence for the latter. A Chi-Square test for categorical variables will be performed for each of the four exposures of interest. All exposures which are significant at p<0.20 as well as clinically important covariates, such as maternal age, pre-existing diabetes, hypertension, and previous history of preeclampsia, will be included in a multiple logistic regression model.

A total of 481,903 pregnancies were included in the study. Of these, 6,863 cases of preeclampsia occurred during the length of the study (1.42% of pregnancies). Data is currently undergoing statistical analysis.

Uncovering data about the interplay between preeclampsia and rural/urban status, ethnicity, immigrant status, and socioeconomic status, may reflect, complement, and enrich etiologic preeclampsia research, as well as potentially provide important information for clinicians and decision-makers about socioeconomic risk factors associated with preeclampsia.