Question About Chances of Developing Pre-eclampsia, Expert Opinions Helpful! - Mothering Forums

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#1 of 16 Old 05-16-2012, 05:36 AM - Thread Starter
 
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This is a pretty theoretical question-- just curious!

 

As I understand it, no one really seems to know what causes pre-eclampsia, but there is a theory (something of a consensus?) that at least part of the risk is correlated to how "familiar" a woman's body is with the baby's father's DNA, so to speak...  For example, risk of pre-e going down with each subsequent baby with the same father.  Or this study, which apparently a lot of women don't want their DHs finding out about!  orngtongue.gif

 

http://www.ncbi.nlm.nih.gov/pubmed/10706945

 

My question is, along those lines, does the length of a sexual relationship before even the very first pregnancy influence the incidence of pre-e?

 

Just looking for studies (I know, not likely), or even just observations by birth professionals...  Anything!

 

I'm curious in part because I have been married for almost 14 years and am just now TTC (actually, I was pregnant and just a few weeks ago m/c at ~10 weeks, but hopefully will be pregnant again soon).  Kind of hoping that gives me a leg up, as I've had, erm-- PLENTY of exposure to my husband's DNA!


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#2 of 16 Old 05-16-2012, 07:59 AM
 
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This might be a good question for the forums at preeclampsia.org.

 

FWIW, I had been married to my husband for 7 years and with him for 8.5 when I developed severe pre-e and had to deliver my first at 32 weeks.  My only risk factor was being overweight - no history of it in my family at all or any previous hypertension.  I also developed severe pre-e and had to deliver at 34 weeks with my second.

 

But the odds are in your favor - most women don't develop pre-e, and a large majority of those that do, develop it at term.  The exceptions can be scary of course, but we're not that common.


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#3 of 16 Old 05-16-2012, 08:08 AM - Thread Starter
 
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Interesting, Bokonon, thanks!


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#4 of 16 Old 05-16-2012, 08:19 AM
 
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I believe the partner theory for pre-eclampsia has been largely discredited.  I can't remember if direct links are ok on this board, so I'll just tell you that preeclamsia dot org 's medical board is made up of some of the top pre-eclampia researchers in the US.  There are several good threads on their boards explaining in more detail why this theory doesn't work.  Essentially, women who have changed partners tend to have had a longer spacing between those pregnancies, and therefore are older.  The link is between age and pre-eclampsia.  When you control for age in the data, the link for having a new partner disappears.

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#5 of 16 Old 05-16-2012, 08:32 AM
 
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Well, that study is about oral ingestion so um, no thanks, but everything I've read indicates multiple pregnancies is a risk factor for pre-e. I've never had it but this being my 8th pregnancy I pay pretty close attention to my blood pressure and other warning signs. 

 

Anecdotally, the women I know who had it were on their 3rd, 5th, and 12th pregnancies. The latter two were both married to the father of all their children, so no new intro of dna there. There is also Mrs. Duggar.


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#6 of 16 Old 05-16-2012, 02:21 PM
 
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Well, that study is about oral ingestion so um, no thanks, but everything I've read indicates multiple pregnancies is a risk factor for pre-e. I've never had it but this being my 8th pregnancy I pay pretty close attention to my blood pressure and other warning signs. 

 

Anecdotally, the women I know who had it were on their 3rd, 5th, and 12th pregnancies. The latter two were both married to the father of all their children, so no new intro of dna there. There is also Mrs. Duggar.

Generally speaking, pre-e is a disease of first pregnancies. I don't know the stats off the top of my head, but overwhelmingly they support that most women who get pre-e are primips.  (I find it SO interesting that you know 3 women who had it in later pregnancies as I have never met anyone, I don't think, who has!)

 

BUT...you are right that in a small-ish study (http://www.ncbi.nlm.nih.gov/pubmed/9486509) grand multips (10+ gestations) had a more than double incidence of pre-e. Even the summary of the study, though, cites this as a function of age. Still, you are wise to be watchful!

 

While the new partner factor has largely been discredited, a family history of pre-e on the part of the PARTNER, not just the mother, is a contributing factor. So a new partner may actually increase pre-e risk in that way.


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#7 of 16 Old 05-16-2012, 03:06 PM - Thread Starter
 
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Very interesting!  Well, then, if "AMA" and whatnot is a factor, that lends some degree of credibility to my theory about why my friends have known SO many women who are diagnosed with pre-e in their teens-- literally MOST of the young women they know (my theory is provider bias, not necessarily reality).

 

Hmmmmm...


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#8 of 16 Old 05-16-2012, 03:08 PM
 
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Originally Posted by buko View Post

Very interesting!  Well, then, if "AMA" and whatnot is a factor, that lends some degree of credibility to my theory about why my friends have known SO many women who are diagnosed with pre-e in their teens-- literally MOST of the young women they know (my theory is provider bias, not necessarily reality).

 

Hmmmmm...

 

Young maternal age is also a risk factor.

 

I know, it's all over the place.  I was 29 when I first developed it.


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#9 of 16 Old 05-16-2012, 03:28 PM - Thread Starter
 
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Well, there goes that!  Given the predominance of diagnoses, I still think there's provider bias at work (for the population I'm thinking of), but perhaps age is not the smoking gun.


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#10 of 16 Old 05-16-2012, 04:37 PM
 
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Well, there goes that!  Given the predominance of diagnoses, I still think there's provider bias at work (for the population I'm thinking of), but perhaps age is not the smoking gun.

There really can't be significant provider bias--the criteria for diagnosing pre-e are really quite concrete.  Because there is a genetic link, it makes sense that particular demographic/ethnic groups would have a higher incidence.

 

Bokonon--I was 29 too :)  But my only risk factor was my husband's family history!


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#11 of 16 Old 05-16-2012, 04:50 PM - Thread Starter
 
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There really can't be significant provider bias--the criteria for diagnosing pre-e are really quite concrete.  Because there is a genetic link, it makes sense that particular demographic/ethnic groups would have a higher incidence.

 

Bokonon--I was 29 too :)  But my only risk factor was my husband's family history!


How can we say that the diagnosis of almost any condition is not subject to provider bias?  Surely you've heard of people being "diagnosed" with probable pre-e after one borderline BP reading (and no proteinuria), etc.?  I certainly have, and that was mostly the case in the people I'm referring to.


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#12 of 16 Old 05-16-2012, 05:35 PM
 
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How can we say that the diagnosis of almost any condition is not subject to provider bias?  Surely you've heard of people being "diagnosed" with probable pre-e after one borderline BP reading (and no proteinuria), etc.?  I certainly have, and that was mostly the case in the people I'm referring to.

 

That sounds more like misdiagnosis.  No proteinuria is not pre-e.

 

These cases, however, are probably more likely at term where the mom is in labor I'm guessing.  Providers are much more likely to be diligent with criteria with preterm and/or severe pre-e.


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#13 of 16 Old 05-16-2012, 05:42 PM - Thread Starter
 
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Yes, I do believe they are misdiagnoses (and more like "probable pre-e"), and based on WAY too little information.  That was my point.  Honestly-- honestly-- the "diagnoses" are made very early on, around 20 weeks, sometimes sooner.  Most of these young women are then induced/sectioned around 38 weeks.  I'm talking poor, young black single moms in urban areas.  There is no way, IMO, that many of those women have actual pre-e (70% of them?)-- especially when I know, in the cases where I have that information, that the "diagnosis" was based literally on one or two borderline BP readings, no protein spilling, no swelling, etc.  It's assembly-line medicine + racism + classism + misogyny.  


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#14 of 16 Old 05-16-2012, 05:55 PM
 
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Yes, I do believe they are misdiagnoses (and more like "probable pre-e"), and based on WAY too little information.  That was my point.  Honestly-- honestly-- the "diagnoses" are made very early on, around 20 weeks, sometimes sooner.  Most of these young women are then induced/sectioned around 38 weeks.  I'm talking poor, young black single moms in urban areas.  There is no way, IMO, that many of those women have actual pre-e (70% of them?)-- especially when I know, in the cases where I have that information, that the "diagnosis" was based literally on one or two borderline BP readings, no protein spilling, no swelling, etc.  It's assembly-line medicine + racism + classism + misogyny.  

 

That's so sad.  :(


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#15 of 16 Old 05-16-2012, 05:57 PM
 
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I wouldn't call that provider bias or misdiagnosis--I'd call that malpractice. It's HIGHLY uncommon for pre-e to present that early and even more unlikely that they would make it to 38w if it did. It's irresponsible medicine "faking" a diagnosis if that is in fact what is happening, and I feel sorry for women who are being manipulated that way.  


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#16 of 16 Old 05-29-2012, 08:22 AM
 
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Well, um, I've had 4 living children and 7 total pregnancies with my dh.  And it was my latest and 4th child that I developed pre-e with.  Apparently I'm an exception to that theory.   And as much as I wanted to resist induction at 38 weeks, I do think it was a valid diagnosis.  I had increasing struggles with BP (including terrible vertigo feelings and brain-fog starting at 32 w), horrible swelling, and then consistent, though minor proteinuria.  My midwives understood my not wanting to induce, but didn't think any providers would take me at 38 weeks with those symptoms and not also want to induce. 

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