1419-P: Pregravid Metabolic Syndrome and Risk of Adverse Outcomes in Pregnancy: A Preconception Cohort Study

Abstract

Women with a history of adverse outcomes in pregnancy (including pre-term birth, delivery of a small-for-gestational-age (SGA) infant, preeclampsia, and gestational diabetes (GDM)) have a higher prevalence of metabolic syndrome (MetS) and cardiovascular disease, as compared to their peers. However, it is not known if MetS precedes the index pregnancy in women who develop these outcomes. Thus, we sought to evaluate the impact of pre-gravid MetS on the risk of adverse outcomes in pregnancy. In this prospective pre-conception cohort study, 1183 newly-married women underwent systematic assessment of cardiovascular risk factors (anthropometry, blood pressure, lipids, glucose) and then were followed across a subsequent pregnancy for the outcomes of interest. The women were stratified into two groups based on the presence (n=49) or absence (n=1134) of pre-gravid MetS (harmonized definition). The groups did not differ in length of gestation (p=0.31) or infant birthweight (p=0.21). Of note, women with pre-gravid MetS were more likely to have a Caesarean delivery (61.4% vs. 38.6%, p=0.003). However, there were no differences between the groups in the incidence of pre-term delivery, SGA, LGA, preeclampsia or GDM (Table). In conclusion, the increased lifetime risk of MetS observed in women with a history of these adverse pregnancy outcomes does not necessarily manifest prior to their pregnancy. Disclosure R. Retnakaran: Consultant; Self; Eli Lilly and Company, Novo Nordisk Inc., Sanofi. Research Support; Self; Boehringer Ingelheim International GmbH, Novo Nordisk Inc. S. Wen: None. H. Tan: None. C. Ye: None. M. Shen: None. G.N. Smith: None. M.C. Walker: None. Funding Canadian Institutes of Health Research