O121. Maternal metabolic outcomes in women with a history of hypertensive pregnancy disorders

Abstract

Introduction Women with preeclampsia or pregnancy induced hypertension (PIH) show metabolic aberrations during pregnancy similar to the metabolic syndrome. These women also are at increased risk of cardiovascular disease later in life. Objective To assess whether women with preeclampsia or PIH have more unfavorable metabolic outcomes six years after pregnancy compared to normotensive women. Methods This study was embedded in the Generation R study, a population-based prospective cohort study. Information on pregnancy and metabolic outcomes six years after pregnancy was available in 4933 women. We measured total body and abdominal fat distribution, weight and plasma lipid concentrations (total cholesterol, LDL-c, HDL-c, triglycerides, Apolipoprotein-B (Apo-B), lipoprotein (a) (lp-a)). Results Compared with normotensive women, women with PIH had higher Apo-B (0.05g/l; 95%CI 0.02, 0.08), LDL-c (0.13 mmol/l; 95%CI 0.04, 0.22), triglyceride (0.11 mmol/l; 95%CI 0.01, 0.21) and total cholesterol concentrations (0.15 mmol/l; 95%CI 0.02, 0.29) and lower HDL-c concentrations (−0.06 mmol/l; 95%CI −0.11, −0.01). No differences were observed in lipid concentrations between normotensive and preeclamptic women. Women with PIH or preeclampsia both had higher body fat percentages (0.03%; 95%CI 0.02, 0.04 and 0.02%; 0.00, 0.04), higher BMI (3.6 kg/m2; 95%CI 2.9, 4.2 and 2.4 kg/m2; 1.4, 3.4, respectively) and increased risk of clustering of metabolic risk factors (OR 2.2; 95%CI 1.4, 3.3 and OR 2.3; 95%CI 1.3, 4.3, respectively) compared with normotensive women. These associations attenuated after adjustment for maternal weight gain after pregnancy. Early pregnancy weight seems to be a predictor for these unfavorable outcomes (figure). Conclusion Hypertensive pregnancy disorders, especially PIH, were associated with adverse metabolic outcomes and an increased risk of clustering of metabolic risk factors six years after pregnancy compared to normotensive women. We therefore advise to perform regular metabolic check-up on these women after delivery. Download : Download full-size image