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Preeclampsia is associated with increased maternal body weight in a northeastern Brazilian population.

ABSTRACT: BACKGROUND: Preeclampsia is a disease with great variability in incidence across the world. The mortality is higher in lower income countries, where it is the leading cause of maternal mortality. This study aimed to determine the frequency of and risk factors for preeclampsia in a low income population from an urban area of Brazil. METHODS: A prospective case control study of 242 women of which 30 developed preeclampsia, 4 had gestational hypertension, 2 had superimposed hypertension, 11 had spontaneous abortion, 13 were lost to follow up and 192 had normal pregnancy. This latter group was considered the normotensive controls. The rate of preeclampsia and the risk of cardiovascular disease, after onset of preeclampsia, were determined. RESULTS: Of the 218 women who completed the study, the frequency of hypertensive disorder of pregnancy was 16.5% (36 of 218) and of preeclampsia was 13.8% (30 of 218). Women with preeclampsia had a higher body mass index (BMI), mean of 25.3?±?4.8 compared to 23.5?±?3.7 for the normotensive controls, p?=?0.02. The risk of preeclampsia increased with BMI [Odds ratio (OR) 1.12, 95% Confidence Interval (CI?=?1.02;1.24, p-value?=?0.023)]. Women with preeclampsia developed chronic hypertension more often than normotensive controls (p?=?0.043) and their systolic and ambulatory blood pressure monitoring was elevated (p?=?0.034). Women with preeclampsia had higher BMI even 5 years post-pregnancy (p?=?0.008). CONCLUSIONS: Women who are overweight or older have an increased risk of preeclampsia. Previous history of preeclampsia increases the risk of early onset of chronic hypertension. Therefore, effective preventive measures are needed, particularly women at lower social economic stratum who have less access to proper medical care and adequate nutrition.

SUBMITTER: Dantas EM

PROVIDER: S-EPMC4231463 | biostudies-other | 2013

REPOSITORIES: biostudies-other

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Preeclampsia is associated with increased maternal body weight in a northeastern Brazilian population.

Dantas Edailna Maria de Melo EM Pereira Flávio Venicio Marinho FV Queiroz José Wilton JW Dantas Diogo Luis de Melo DL Monteiro Gloria Regina Gois GR Duggal Priya P Azevedo Maria de Fatima Mde F Jeronimo Selma Maria Bezerra SM Araújo Ana Cristina Pinheiro Fernandes AC

BMC pregnancy and childbirth 20130808

<h4>Background</h4>Preeclampsia is a disease with great variability in incidence across the world. The mortality is higher in lower income countries, where it is the leading cause of maternal mortality. This study aimed to determine the frequency of and risk factors for preeclampsia in a low income population from an urban area of Brazil.<h4>Methods</h4>A prospective case control study of 242 women of which 30 developed preeclampsia, 4 had gestational hypertension, 2 had superimposed hypertensio ...[more]

PMID: 23927768

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Project description:A suboptimal intrauterine environment has been postulated to have adverse long-term health effects, including an increased risk of osteoporosis. Because preeclampsia (PE) and to a lesser extent gestational hypertension (GH) are associated with impaired placental function, we postulated that these represent hitherto unrecognized risk factors for reduced bone mineral density (BMD) of the offspring. The objective of this study was to investigate if exposure to PE or GH in utero is associated with BMD of the offspring as measured in late adolescence. Mother-offspring pairs from the UK population-based cohort study, Avon Longitudinal Study of Parents and Children (ALSPAC), were investigated (n = 3088 with relevant data). Multivariable linear regression was used to examine associations between PE/GH and total body, spine, and total hip BMD at age 17 years. Of the 3088 mother-offspring pairs, 2% (n = 60) of the mothers fulfilled criteria for PE and 14% (n = 416) for GH. In confounder-adjusted analyses (ie, age of scan, gender, maternal factors, including BMI, offspring height, fat mass, and lean mass), PE was negatively associated with BMD at the hip (SD difference -0.30; 95%CI, -0.50 to -0.10). This association was not attenuated by further adjustment for gestational age and birth weight, which were hypothesized to be on the causal pathway. There was also weak evidence for a negative association between PE and total body BMD (SD difference -0.17; 95% CI, -0.36 to 0.02), whereas no relationship was evident at the spine (SD difference -0.11; 95% CI, -0.30 to 0.09). In contrast, a positive association of GH with offspring total body, hip, and spine BMD attenuated to the null with adjustment for confounders, in particular confounding via the maternal and offspring adiposity/size and the link between the two. Modest negative associations from exposure to PE, but not GH may represent a hitherto unrecognized risk factor for low BMD. Further exploration of the causal relationship of the in utero environment on subsequent offspring bone health is required.

Dataset Information

Preeclampsia is associated with increased maternal body weight in a northeastern Brazilian population.

Publications

Preeclampsia is associated with increased maternal body weight in a northeastern Brazilian population.

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