71 Maternal body composition and energy metabolism 6 months postpartum in women with a normotensive versus hypertensive pregnancy

Abstract

Introduction Increased body fat is associated with detrimental metabolic outcomes, however it is unclear whether there are differences in body composition in postpartum women after normotensive/uncomplicated pregnancy (NP) versus hypertensive pregnancy (HTP). Objectives To determine differences in body composition and energy metabolism six months postpartum in women who had a normotensive versus hypertensive pregnancy. We hypothesised that there would be a higher percent body fat (BF%), and altered energy intake (EI) and total energy expenditure (TEE) in women after hypertensive versus normotensive pregnancy. Methods Body composition (BF%, lean body mass – LBM) and energy metabolism (EI and TEE) were measured 6 months postpartum in NP women ( n = 42) and HTP women ( n = 14). Women were recruited from the longitudinal P4 study (2013-ongoing) at St George Hospital, Sydney. BF% and LBM were measured using multi-frequency bio-impedance analysis. TEE was measured using the SenseWear Armband, worn over 24 h. This also measures metabolic equivalents (MET’s): the energy cost of a physical activity. Finally, EI was measured using a three-day food recall diary and analysed using Foodworks. Results There are significant differences in body composition and energy balance between healthy and hypertensive women at 6 months postpartum (Table). HTP women had a higher BMI ( p = 0.02) and on average 5% more body fat than NP women ( p = 0.03), whilst LBM was similar between groups. There was no significant difference in EI between groups. TEE was similar between groups, but average METs were significantly lower in the hypertensive group ( p = 0.03). Conclusion Six months postpartum, women who had hypertension in pregnancy have a higher BMI and more body fat than women with normotensive pregnancy. MET results show that previously hypertensive women metabolise less energy for a given physical activity compared to healthy women. This suggests a change in metabolic state, involving increased metabolic efficiency and energy conservation. Six months postpartum may be an important time for identification and potential intervention to alter maternal risk profiles and negative long-term trajectory for women with hypertensive disorders of pregnancy. Patient demographics, body composition and energy balance 6 months after normotensive versus hypertensive pregnancy.