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Pregnancy-induced hypertension in North Carolina, 1988 and 1989.

D A Savitz and J Zhang

Department of Epidemiology, School of Public Health, University of North Carolina, Chapel Hill 27599-7400.

INTRODUCTION. Pregnancy-induced hypertension (PIH) is a highly prevalent pregnancy complication with adverse effects on maternal and infant health. Epidemiologic research concerning its etiology is limited. METHODS. Birth records from North Carolina for the period 1988 through 1989 included an indication of the presence of PIH. The risk of PIH was examined in relation to several maternal characteristics and exposures, including reproductive history, demographic characteristics, and tobacco use during pregnancy. Risk ratio estimates, adjusted for confounders, were calculated contrasting PIH among exposed vs unexposed women. RESULTS. The overall risk of PIH was 43.1 per 1000 births, with multiple pregnancies, nulliparity, and advanced maternal age associated with markedly increased risks. Tobacco use was inversely associated with PIH, and Blacks and Whites were at virtually equal risk. CONCLUSIONS. Problems in diagnosis and classification impede research in this area, with birth certificates limited in quality and breadth of information. Nonetheless, several patterns emerged that are worthy of further epidemiologic evaluation using more sophisticated designs.

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