Preterm preeclampsia in relation to country of birth

Objective:to examine the association between maternal country of birth and the risk of preeclampsia+preterm birth (ptb).study design:we completed a population-based study in the entire province of ontario, where there is universal access to obstetrical care. we included 881 700 singleton livebirths among canadian-born mothers and 305 547 births among immigrant mothers. adjusted risk ratios (arrs) were adjusted for maternal age, parity and income quintile.results:compared with a rate of preeclampsia+ptb of 4.0 per 1000 among canadian-born mothers, the arr of preeclampsia+ptb at 24 to 36 weeks was significantly higher for immigrant women from nigeria (1.79, 95% confidence interval (ci) 1.12 to 2.84), the philippines (1.54, 95% ci 1.30 to 1.86), colombia (1.68, 95% ci 1.04 to 2.73), jamaica (2.06, 95% ci 1.66 to 2.57) and ghana (2.12, 95% ci 1.40 to 3.21). the arrs generally followed a similar pattern for secondary outcomes. specifically, women from ghana were at highest risk of preeclampsia+very ptb (4.55, 95% ci 2.57 to 8.06), and women from jamaica at the highest risk of preeclampsia+indicated ptb (1.89, 95% ci 1.43 to 2.50).conclusion:the risk of preeclampsia+ptb is highest among women from a select number of countries. this information can enhance initiatives aimed at reducing the risk of ptb related to preeclampsia.