Excess Maternal Body Weight and Preeclampsia/Eclampsia Risk among Women in San Bernardino County, 2007-2008

Fiona Lewis

doi:10.17303/jfn.2014.104

Abstract

Objective: An association between maternal adiposity and preeclampsia has been found in several large U.S. studies. The objective of our study was to examine the association between maternal body weight (recommended weight gain categories, pre-pregnancy BMI categories) and preeclampsia/eclampsia in the analysis of all births occurring in San Bernardino County during 2007 and 2008. Methods: A retrospective cohort study was conducted using information from the San Bernardino County birth cohort files of live births occurring between 2007-2008 (N=65 228). We conducted logistic regression analyses to examine the relationship between pre-pregnancy body mass index (BMI), Institute of Medicine qualitative weight gain (IOM-QWG), and preeclampsia/eclampsia outcomes, controlling for socio-demographic factors and surrogate measures of socioeconomic status that included participation in the Women, Infants, Children (WIC) Supplemental Nutrition Program, and maternal education. Results: Using BMI 18.5-24.9 as the reference category, we found that pre-pregnancy BMI was associated with preeclampsia/eclampsia in 2007 (OR [95% CI] = 0.52 [0.31, 0.86] for BMI 30) and 2008 (0.90 [0.58, 1.40], BMI 30.0). Gaining “too much” weight according to IOM-QWG guidelines was associated with the increased odds of preeclampsia/eclampsia in 2007 (OR=1.60 [1.32, 1.92]) and 2008 (OR=1.84 [1.50-2.25]) using “just right” as the reference category.

Highlights

Preeclampsia is a hypertensive condition of pregnancy diagnosed when a woman with no history of hypertension develops hypertension and proteinuria after 20 weeks of gestation [1]
Using body mass index (BMI) 18.5-24.9 as the reference category, we found that pre-pregnancy BMI was associated with preeclampsia/eclampsia in 2007 (OR [95% CI] = 0.52 [0.31, 0.86] for BMI < 18.5; 1.40 [1.14, 1.71] for BMI 25.0 to 29.9 and 2.36 [1.97, 2.84] for BMI >30) and 2008 (0.90 [0.58, 1.40], BMI 30.0)
Odds ratios for the associations between maternal pre-pregnancy BMI and Institute of Medicine (IOM) weight gain recommendations and preeclampsia/eclampsia are illustrated in tables 2 and 3, respectively

Summary

Introduction

Preeclampsia is a hypertensive condition of pregnancy diagnosed when a woman with no history of hypertension develops hypertension and proteinuria after 20 weeks of gestation [1]. Preeclampsia affects multiple maternal organs including the liver, brain, and kidneys [2, 3]. Maternal pre-pregnancy body mass index (BMI) classified as overweight and obese are associated modifiable risk factors for preeclampsia [5, 6]. Obese pregnant women (BMI >30kg/m2) experience a nearly three-fold increase in developing preeclampsia compared to women of normal weight (BMI 18.5-

Methods

Results

Discussion

Conclusion