The Problem Cardiovascular disease is the leading killer of women in the United States. Preeclampsia often presents as new-onset hypertension and proteinuria after 20 weeks of gestation. Some women experiencing preeclampsia may develop eclampsia, a life-threatening condition that involves seizures and coma. Preeclampsia/eclampsia disproportionally affects non-Hispanic black women. While 4% non-Hispanic white women experience preeclampsia or eclampsia in child deliveries, the number for non-Hispanic black women is 7%. Moreover, black women were more likely than women of other races/ethnicities to have a more severe diagnosis such as eclampsia and severe preeclampsia. The Approach To address this challenge, Dr. Liu and his colleagues will evaluate the importance of both maternal clinical factors and race/ethnicity in predicting the occurrence of preeclampsia or eclampsia using electronic medical record (EMR) data from a large integrated health system in the US. The team will: Assess whether race/ethnicity is an independent risk factor controlling for maternal clinical characteristics. Establish a preeclampsia/eclampsia risk index that include maternal clinical characteristics, race/ethnicity, and other sociodemographic factors. Incorporate the risk model into the EMR to inform clinical decision making in real time. Community/Culture: Enhance clinicians’ screening practices and inform targeted mitigation strategies for women at higher risk of preeclampsia and eclampsia, while addressing and reducing the effects of systemic racism on healthcare delivery and health outcomes. Policy: Advocate for regulations that limit the uses of antibiotics and reduce environmental discharge of effluents with the potential to exacerbate AMR Develop a Preeclampsia/eclampsia Risk Index to Reduce Racial Disparities “To unleash the great potential of big data in healthcare, we need to create the opportunities for clinicians and researchers to work together to generate actionable insights.” Xinliang (Albert) Liu, PhD Short Term Impact While a growing body of literature has begun to shine light on the risk factors, including race/ethnicity, for developing preeclampsia during pregnancy, our research will assess how race/ethnicity affects the occurrence of preeclampsia/eclampsia using EMR data from the United States. Building the risk model on a heterogeneous population that is more representative of the US patient population will make the risk assessment tool more generalizable and accurate. Longer Term Impact Our findings will inform the development of a risk assessment score based on clinical and race/ethnicity factors that can be incorporated in the patient dashboard. Clinicians can receive real-time feedback once an expectant mother with a high risk of developing preeclampsia/eclampsia is detected, which will directly improve the care of at-risk patients. Societal Impact This study has societal benefits in these domains: Health: Preeclampsia/eclampsia can lead to devastating maternal and neonatal morbidity and mortality. This research effort can potentially alleviate the racial disparities in the burden of preeclampsia/eclampsia. This research will impact the community in the following areas: For more information visit https://health.lehigh.edu/research-partners or email INRSRCH@lehigh.edu 22
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