(806) Neighborhood deprivation and preeclampsia or eclampsia in high-risk pregnancy

Area Deprivation Index (ADI) is a composite score of socioeconomic factors created to study the effect of neighborhood deprivation on various health outcomes. Preeclampsia is a leading cause of adverse maternal and neonatal outcomes, yet the relationship between neighborhood deprivation and preeclampsia remains understudied. We aimed to quantify the association between ADI and preeclampsia or eclampsia.


Study Design: This is a secondary analysis of a large NIH-funded retrospective cohort of 11,137 patients with singleton pregnancies complicated by having chronic hypertension, diabetes, or fetal growth restriction who delivered between January 2002 and March 2013. Patient address at time of delivery was linked to nationally ranked ADI scores. ADI were stratified into quartiles, with higher quartiles representing worse deprivation. The primary outcome was diagnosis of preeclampsia or eclampsia. Secondary outcome was gestational age (GA) at delivery among patients with preeclampsia or eclampsia. Modified Poisson regression assessed the risk of preeclampsia or eclampsia by ADI quartile. Similarly, Cox proportional hazards regression for the hazard of gestational age at delivery were performed with adjustments for confounders.

Results:

Of the 11,137 in the parent study, 1,785 (15.7%) were diagnosed with preeclampsia or eclampsia; 210 (11.8%) resided in the least deprived ADI quartile, 778 (43.6%) 2nd quartile, 714 (40%) 3rd quartile and 83 (4.6%) in the most deprived quartile. Compared to the least deprived neighborhood, residing in the 2nd or 3rd-deprivedquartiles—but not the most deprived quartile—had an increased adjusted relative risk (aRR) of preeclampsiaor eclampsia (aRR 1.20 [95% CI 1.05 - 1.38] & aRR 1.19 [95% CI 1.03 - 1.37]), respectively. GA at delivery was not statistically different by neighborhood deprivation.


Conclusion:

Neighborhood deprivation may be associated with preeclampsia or eclampsia. As this study was conducted in a high-risk population, further research is needed in a population-based sample to clarify findings.