Revisiting the epidemiological standard of preeclampsia: primigravidity or primipaternity?

Pregnancy-induced hypertensive disorders, and especially preeclampsia, are documented to occur primarily in first pregnancies and rarely in subsequent pregnancies. Therefore, the concept of primigravidity is the epidemiological cornerstone of this disease. The authors propose a concept in which preeclampsia is a disease of new couples, especially after a short period of sexual cohabitation, and explore if this alternative primipaternity model, as compared with the primigravidity concept, provides a better fit with well-known epidemiologic descriptions. First, the primipaternity model provides a mathematical modelling which may explain the prevalence of approximately 10% in long-term monogamic populations. Further, it proposes explanations for many epidemiological descriptions which were previously difficult to understand and assemble in a single concept. (C) 1999 Elsevier Science Ireland Ltd. All rights reserved.