Which is the strongest predictor of preeclampsia: maternal ethnicity, paternal ethnicity, or parental ethnic discordance?


      To examine rates of preeclampsia associated with both maternal and paternal ethnicity.

      Study design

      Retrospective cohort study of all women delivered from Jan 1, 1995, to December 31, 1999, within a mature managed care network. Rates of preeclampsia were calculated for maternal, paternal, and combined ethnicity. Results were examined in both univariate and multivariate analyses.


      Among the 144,749 women with an identified ethnicity, when examining maternal ethnicity in a multivariate model controlling for maternal age, parity, education, and gestational age, we found that the rates of preeclampsia were higher among Latina (OR 1.21) and African American (OR 1.21) women and lower among Asian women (OR 0.87) with all results having a P value <0.001 as compared to Caucasian women. This difference persisted when controlling for same vs discordant paternal ethnicity, with parental ethnic discordance associated with an increase in the rate of preeclampsia (OR 1.07, P = 0.04) when compared to parental ethnic concordance. However, when paternal ethnicity is controlled for separately, the difference in the rate of preeclampsia among Asian women disappeared, and Asian paternity was found to have the lowest rate of preeclampsia (OR 0.76, P<0.001) compared to all other paternal ethnicity.


      We found that rates of preeclampsia are affected by paternal ethnicity. Both the actual paternal ethnicity itself and having a different ethnicity from that of the pregnant woman were associated with different rates of preeclampsia. These differences may be useful in further investigation of the etiology of preeclampsia.