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dc.contributor.authorRoberts, Christineen_US
dc.contributor.authorFord, Jane Ben_US
dc.contributor.authorAlgert, Charles Sen_US
dc.contributor.authorAntonsen, Sussieen_US
dc.contributor.authorChalmers, Jamesen_US
dc.contributor.authorCnattingius, Svenen_US
dc.contributor.authorGokhale, Manjushaen_US
dc.contributor.authorKotelchuck, Miltonen_US
dc.contributor.authorMelve, Kari Klungsøyren_US
dc.contributor.authorLangridge, Amandaen_US
dc.contributor.authorMorris, Caroleen_US
dc.contributor.authorMorris, Jonathan M.en_US
dc.contributor.authorNassar, Natashaen_US
dc.contributor.authorNorman, Jane E.en_US
dc.contributor.authorNorrie, Johnen_US
dc.contributor.authorSørensen, Henrik Toften_US
dc.contributor.authorWalker, Robinen_US
dc.contributor.authorWeir, Christopher J.en_US
dc.date.accessioned2015-04-13T09:46:29Z
dc.date.available2015-04-13T09:46:29Z
dc.date.issued2011-05-24eng
dc.identifier.issn2044-6055
dc.identifier.urihttps://hdl.handle.net/1956/9768
dc.description.abstractObjective: The objective of this study was to compare international trends in pre-eclampsia rates and in overall pregnancy hypertension rates (including gestational hypertension, pre-eclampsia and eclampsia). Design: Population data (from birth and/or hospital records) on all women giving birth were available from Australia (two states), Canada (Alberta), Denmark, Norway, Scotland, Sweden and the USA (Massachusetts) for a minimum of 6 years from 1997 to 2007. All countries used the 10th revision of the International Classification of Diseases, except Massachusetts which used the 9th revision. There were no major changes to the diagnostic criteria or methods of data collection in any country during the study period. Population characteristics as well as rates of pregnancy hypertension and pre-eclampsia were compared. Results: Absolute rates varied across the populations as follows: pregnancy hypertension (3.6% to 9.1%), pre-eclampsia (1.4% to 4.0%) and early-onset preeclampsia (0.3% to 0.7%). Pregnancy hypertension and/or pre-eclampsia rates declined over time in most populations. This was unexpected given that factors associated with pregnancy hypertension such as prepregnancy obesity and maternal age are generally increasing. However, there was also a downward shift in gestational age with fewer pregnancies reaching 40 weeks. Conclusion: The rate of pregnancy hypertension and pre-eclampsia decreased in northern Europe and Australia from 1997 to 2007, but increased in Massachusetts. The use of a different International Classification of Diseases coding version in Massachusetts may contribute to the difference in trend. Elective delivery prior to the due date is the most likely explanation for the decrease observed in Europe and Australia. Also, the use of interventions that reduce the risk of pregnancy hypertension and/or progression to pre-eclampsia (low-dose aspirin, calcium supplementation and early delivery for mild hypertension) may have contributed to the decline.en_US
dc.language.isoengeng
dc.publisherBMJeng
dc.rightsAttribution-NonCommercial CC BY-NCeng
dc.rights.urihttp://creativecommons.org/licenses/by-nc/2.0/eng
dc.titlePopulation-based trends in pregnancy hypertension and pre-eclampsia: an international comparative studyen_US
dc.typePeer reviewed
dc.typeJournal article
dc.date.updated2015-04-01T08:38:43Zen_US
dc.description.versionpublishedVersionen_US
dc.rights.holderCopyright the authors
dc.source.articlenumbere000101
dc.identifier.doihttps://doi.org/10.1136/bmjopen-2011-000101
dc.identifier.cristin909456
dc.source.journalBMJ Open
dc.source.401
dc.source.141


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