Towards the Development of a Conceptual Framework of the Determinants of Pre-Eclampsia: A Hierarchical Systematic Review of Social Determinants

The PRECISE Network

doi:10.1111/1471-0528.18082

Towards the Development of a Conceptual Framework of the Determinants of Pre-Eclampsia: A Hierarchical Systematic Review of Social Determinants

The PRECISE Network

Research output: Contribution to journal › Article › peer-review

1 Citation (Scopus)

Abstract

Background: Existing reviews of pre-eclampsia determinants have focused on clinical and genetic risk factors. Objective: To evaluate social determinants for pre-eclampsia prevention. Search Strategy: Systematic searches were conducted from relevant electronic databases from inception of each database to 30th December 2024. Selection Criteria: Reviews and large cohort studies (≥ 1000 participants), published between 2013 and 2024, reporting quantitative associations between social determinant exposures and pre-eclampsia outcomes. Data Collection and Analysis: Titles and abstracts, then relevant full-texts were reviewed by two reviewers, independently. Strength of association was evaluated as ‘definite’ (odds ratios [OR] or relative risk [RR] ≥ 3.00 or < 0.33), ‘probable’ (OR or RR 1.50–2.99 or 0.33–0.67), ‘possible’ (OR or RR 1.10–1.49 or 0.68–0.89), or ‘unlikely’ (OR or RR 0.90–1.09). Quality of the evidence was high, moderate, low, or very-low, using GRADE. Main Results: Twenty-seven publications found 24 associations of pre-eclampsia with socioeconomic status, social support/exclusion, healthcare access, and occupational and physical environmental factors. One association (polygamy) was definite (low-quality evidence). Probable associations included: work stress, lack of antenatal care and heat exposure in early pregnancy (high-quality evidence); prolonged occupational exposure to whole body vibrations or bending, distance to health facility, and UV-B radiation exposure (protective factor), all based on moderate-quality evidence; and neighbourhood deprivation, rotating work shifts, and Asian/Oceanian origins (protective factor), all based on low-quality evidence. There were 13 possible associations, which did not include education. Conclusion: Our findings support recommendations to address climate change, strengthen occupational protection, and promote early antenatal attendance. Social determinants may be indicative of upstream factors (e.g., obesity) that increase likelihood of clinical risk factors for pre-eclampsia incidence and severity.

Original language	English
Journal	BJOG: An International Journal of Obstetrics and Gynaecology
DOIs	https://doi.org/10.1111/1471-0528.18082
Publication status	Accepted/In press - 2025

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.1111/1471-0528.18082

Cite this

@article{33efa49fd7234465a28f8ebf8ccb30c7,

title = "Towards the Development of a Conceptual Framework of the Determinants of Pre-Eclampsia: A Hierarchical Systematic Review of Social Determinants",

abstract = "Background: Existing reviews of pre-eclampsia determinants have focused on clinical and genetic risk factors. Objective: To evaluate social determinants for pre-eclampsia prevention. Search Strategy: Systematic searches were conducted from relevant electronic databases from inception of each database to 30th December 2024. Selection Criteria: Reviews and large cohort studies (≥ 1000 participants), published between 2013 and 2024, reporting quantitative associations between social determinant exposures and pre-eclampsia outcomes. Data Collection and Analysis: Titles and abstracts, then relevant full-texts were reviewed by two reviewers, independently. Strength of association was evaluated as {\textquoteleft}definite{\textquoteright} (odds ratios [OR] or relative risk [RR] ≥ 3.00 or < 0.33), {\textquoteleft}probable{\textquoteright} (OR or RR 1.50–2.99 or 0.33–0.67), {\textquoteleft}possible{\textquoteright} (OR or RR 1.10–1.49 or 0.68–0.89), or {\textquoteleft}unlikely{\textquoteright} (OR or RR 0.90–1.09). Quality of the evidence was high, moderate, low, or very-low, using GRADE. Main Results: Twenty-seven publications found 24 associations of pre-eclampsia with socioeconomic status, social support/exclusion, healthcare access, and occupational and physical environmental factors. One association (polygamy) was definite (low-quality evidence). Probable associations included: work stress, lack of antenatal care and heat exposure in early pregnancy (high-quality evidence); prolonged occupational exposure to whole body vibrations or bending, distance to health facility, and UV-B radiation exposure (protective factor), all based on moderate-quality evidence; and neighbourhood deprivation, rotating work shifts, and Asian/Oceanian origins (protective factor), all based on low-quality evidence. There were 13 possible associations, which did not include education. Conclusion: Our findings support recommendations to address climate change, strengthen occupational protection, and promote early antenatal attendance. Social determinants may be indicative of upstream factors (e.g., obesity) that increase likelihood of clinical risk factors for pre-eclampsia incidence and severity.",

author = "{The PRECISE Network} and Kinshella, {Mai Lei Woo} and Kelly Pickerill and Sarina Prasad and Olivia Campbell and Jalila Devji and Lopes, {L{\'i}via Vieira} and Rosa Balleny and Terteel Elawad and Rachel Craik and Volvert, {Marie Laure} and Mistry, {Hiten D.} and Hannah Blencowe and V{\'e}ronique Filippi and {von Dadelszen}, Peter and Magee, {Laura A.} and Marianne Vidler",

note = "Publisher Copyright: {\textcopyright} 2025 John Wiley & Sons Ltd.",

year = "2025",

doi = "10.1111/1471-0528.18082",

language = "English",

journal = "BJOG: An International Journal of Obstetrics and Gynaecology",

issn = "1470-0328",

publisher = "Blackwell Publishing Ltd",

}

TY - JOUR

T1 - Towards the Development of a Conceptual Framework of the Determinants of Pre-Eclampsia

T2 - A Hierarchical Systematic Review of Social Determinants

AU - The PRECISE Network

AU - Kinshella, Mai Lei Woo

AU - Pickerill, Kelly

AU - Prasad, Sarina

AU - Campbell, Olivia

AU - Devji, Jalila

AU - Lopes, Lívia Vieira

AU - Balleny, Rosa

AU - Elawad, Terteel

AU - Craik, Rachel

AU - Volvert, Marie Laure

AU - Mistry, Hiten D.

AU - Blencowe, Hannah

AU - Filippi, Véronique

AU - von Dadelszen, Peter

AU - Magee, Laura A.

AU - Vidler, Marianne

PY - 2025

Y1 - 2025

N2 - Background: Existing reviews of pre-eclampsia determinants have focused on clinical and genetic risk factors. Objective: To evaluate social determinants for pre-eclampsia prevention. Search Strategy: Systematic searches were conducted from relevant electronic databases from inception of each database to 30th December 2024. Selection Criteria: Reviews and large cohort studies (≥ 1000 participants), published between 2013 and 2024, reporting quantitative associations between social determinant exposures and pre-eclampsia outcomes. Data Collection and Analysis: Titles and abstracts, then relevant full-texts were reviewed by two reviewers, independently. Strength of association was evaluated as ‘definite’ (odds ratios [OR] or relative risk [RR] ≥ 3.00 or < 0.33), ‘probable’ (OR or RR 1.50–2.99 or 0.33–0.67), ‘possible’ (OR or RR 1.10–1.49 or 0.68–0.89), or ‘unlikely’ (OR or RR 0.90–1.09). Quality of the evidence was high, moderate, low, or very-low, using GRADE. Main Results: Twenty-seven publications found 24 associations of pre-eclampsia with socioeconomic status, social support/exclusion, healthcare access, and occupational and physical environmental factors. One association (polygamy) was definite (low-quality evidence). Probable associations included: work stress, lack of antenatal care and heat exposure in early pregnancy (high-quality evidence); prolonged occupational exposure to whole body vibrations or bending, distance to health facility, and UV-B radiation exposure (protective factor), all based on moderate-quality evidence; and neighbourhood deprivation, rotating work shifts, and Asian/Oceanian origins (protective factor), all based on low-quality evidence. There were 13 possible associations, which did not include education. Conclusion: Our findings support recommendations to address climate change, strengthen occupational protection, and promote early antenatal attendance. Social determinants may be indicative of upstream factors (e.g., obesity) that increase likelihood of clinical risk factors for pre-eclampsia incidence and severity.

AB - Background: Existing reviews of pre-eclampsia determinants have focused on clinical and genetic risk factors. Objective: To evaluate social determinants for pre-eclampsia prevention. Search Strategy: Systematic searches were conducted from relevant electronic databases from inception of each database to 30th December 2024. Selection Criteria: Reviews and large cohort studies (≥ 1000 participants), published between 2013 and 2024, reporting quantitative associations between social determinant exposures and pre-eclampsia outcomes. Data Collection and Analysis: Titles and abstracts, then relevant full-texts were reviewed by two reviewers, independently. Strength of association was evaluated as ‘definite’ (odds ratios [OR] or relative risk [RR] ≥ 3.00 or < 0.33), ‘probable’ (OR or RR 1.50–2.99 or 0.33–0.67), ‘possible’ (OR or RR 1.10–1.49 or 0.68–0.89), or ‘unlikely’ (OR or RR 0.90–1.09). Quality of the evidence was high, moderate, low, or very-low, using GRADE. Main Results: Twenty-seven publications found 24 associations of pre-eclampsia with socioeconomic status, social support/exclusion, healthcare access, and occupational and physical environmental factors. One association (polygamy) was definite (low-quality evidence). Probable associations included: work stress, lack of antenatal care and heat exposure in early pregnancy (high-quality evidence); prolonged occupational exposure to whole body vibrations or bending, distance to health facility, and UV-B radiation exposure (protective factor), all based on moderate-quality evidence; and neighbourhood deprivation, rotating work shifts, and Asian/Oceanian origins (protective factor), all based on low-quality evidence. There were 13 possible associations, which did not include education. Conclusion: Our findings support recommendations to address climate change, strengthen occupational protection, and promote early antenatal attendance. Social determinants may be indicative of upstream factors (e.g., obesity) that increase likelihood of clinical risk factors for pre-eclampsia incidence and severity.

UR - http://www.scopus.com/inward/record.url?scp=85219214542&partnerID=8YFLogxK

U2 - 10.1111/1471-0528.18082

DO - 10.1111/1471-0528.18082

M3 - Article

AN - SCOPUS:85219214542

SN - 1470-0328

JO - BJOG: An International Journal of Obstetrics and Gynaecology

JF - BJOG: An International Journal of Obstetrics and Gynaecology

ER -

Towards the Development of a Conceptual Framework of the Determinants of Pre-Eclampsia: A Hierarchical Systematic Review of Social Determinants

Abstract

UN SDGs

Access to Document

Other files and links

Fingerprint

Cite this