Abstract:
Preeclampsia is a multifactorial pathology with negative outcomes in affected patients in both the peripartum and postpartum period. Black patients in the United States, when compared to their White and Hispanic counterparts, have higher rates of preeclampsia. This article aims to review the current literature to investigate how race, social determinants of health, and genetic profiles influence the prevalence and outcomes of patients with preeclampsia. Published studies utilized in this review were identified through PubMed using authors\' topic knowledge and a focused search through a Medline search strategy. These articles were thoroughly reviewed to explore the contributing biosocial factors, genes/biomarkers, as well as negative outcomes associated with disparate rates of preeclampsia. Increased rates of contributing comorbidities, including hypertension and obesity, which are largely associated with low access to care in Black patient populations lead to disparate rates of preeclampsia in this population. Limited research shows an association between increased rate of preeclampsia in Black patients and specific APOL1, HLA-G, and PP13 gene polymorphisms as well as factor V Leiden mutations. Further research is required to understand the use of certain biomarkers in predicting preeclampsia within racial populations. Understanding contributing biosocial factors and identifying genes that may predispose high-risk populations may help to address the disparate rates of preeclampsia in Black patients as described in this review. Further research is required to understand if serum, placental, or urine biomarkers may be used to predict individuals at risk of developing preeclampsia in pregnancy. KEY POINTS: · Prevalence of preeclampsia in the U.S. is higher in Black patients compared to other racial groups.. · Patients with preeclampsia are at risk for poorer health outcomes both during and after delivery.. · Limited research suggests specific biomarkers or gene polymorphisms contribute to this difference; however, explanations for this disparity are multifactorial and further investigation is necessary..
摘要:
目的:先兆子痫是一种多因素病理,受累患者在围产期和产后均有阴性结局。美国的黑人患者,与白人和西班牙裔相比,先兆子痫的发生率较高。本文旨在回顾当前的文献,探讨种族,健康的社会决定因素,和遗传特征影响先兆子痫患者的患病率和结局。
方法:本综述中使用的发表的研究是通过PubMed使用作者的主题知识和通过Medline搜索策略进行的集中搜索来确定的。对这些文章进行了彻底的审查,以探讨促成生物社会因素,基因/生物标志物,以及与不同先兆子痫发生率相关的负面结果。
结果:造成合并症的比率增加,包括高血压和肥胖症,这在很大程度上与黑人患者人群获得护理的机会低相关,导致该人群中子痫前期的发病率不同.有限的研究表明,布莱克患者先兆子痫的发生率与特定的APOL1,HLA-G,和PP13基因多态性以及因子V莱顿突变。需要进一步的研究来了解某些生物标志物在预测种族人群中先兆子痫中的用途。
结论:了解影响生物社会因素和识别可能易患高危人群的基因可能有助于解决本综述中所述的黑人患者不同的先兆子痫发生率。需要进一步的研究来了解血清,胎盘,或尿液生物标志物可用于预测在怀孕期间有先兆子痫风险的个体。