Abstract
INTRODUCTION: Preeclampsia is a leading cause of morbidity and mortality for mothers and neonates. We examined births between 2009 and 2018 in the University of Washington medical system (UW) to assess the associations between maternal body weight, body mass index (BMI), blood pressure prior to and early in pregnancy and preeclampsia. METHODS: Retrospective data-pull of births at UW. Analysis of variance and Chi Square were used to compare pregnancies with and without preeclampsia for maternal pre-pregnancy weight, BMI, pre- and early pregnancy blood pressure, and birth weight. RESULTS: Of the 5,972 births, 1024 (17.1%) were complicated with preeclampsia. Women with preeclampsia were twice as likely to deliver preterm (28.0% versus 13.2%; P<.001); 30.5% of preterm births were complicated with preeclampsia. Women who experienced preeclampsia were heavier (81.6±1.5 kg versus 70.5±0.5 kg) with higher BMI (30.25±0.52 versus 26.22±0.18; P<.001 for both). Obese women were twice as likely to develop preeclampsia (27.5% versus 11.4% for non-obese women). Blood pressure was higher in women who developed preeclampsia at 6–9 months preconception, 0–6 months preconception, and within the first and second trimesters (P<.001 for all). Among women diagnosed with pre-existing hypertension (1,290; 21.6%), 77.3% developed preeclampsia compared to 0.6% in women without pre-existing hypertension (P<.001). The high proportion of preeclamptic pregnancies that were preterm resulted in lower mean birthweight, but term infants did not differ. CONCLUSION: Obesity and elevated blood pressure as long as 9 months preconception and during early pregnancy were associated with preeclampsia. A diagnosis of hypertension pre-pregnancy is strongly associated with preeclampsia.
Published Version
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