Abstract
BackgroundTo evaluate the independent and joint effects of maternal pre-pregnancy BMI and gestational weight gain (GWG) on the risk of preeclampsia and its subtypes.MethodsA birth cohort study was conducted from 2010 to 2012 in Lanzhou, China. Three hundred fourty seven pregnant women with preeclampsia and 9516 normotensive women at Gansu Provincial Maternity and Child Care Hospital were included in the present study. Unconditional logistic regression models were used to evaluate the associations between pre-pregnancy BMI, GWG, and risk of preeclampsia and its subtypes.ResultsCompared to women with normal pre-pregnancy BMI, those who were overweight/obese had an increased risk of preeclampsia (OR = 1.81; 95%CI: 1.37–2.39). Women with excessive GWG had an increased risk of preeclampsia (OR = 2.28; 95%CI: 1.70–3.05) compared to women with adequate GWG. The observed increased risk was similar for mild-, severe- and late-onset preeclampsia. No association was found for early-onset preeclampsia. Overweight/obese women with excessive GWG had the highest risk of developing preeclampsia compared to normal weight women with no excessive weight gain (OR = 3.78; 95%CI: 2.65–5.41).ConclusionsOur results suggested that pre-pregnancy BMI and GWG are independent risk factors for preeclampsia and that the risk might vary by preeclampsia subtypes. Our study also proposed a potential synergistic effect of pre-pregnancy BMI and GWG that warrants further investigation.
Highlights
To evaluate the independent and joint effects of maternal pre-pregnancy BMI and gestational weight gain (GWG) on the risk of preeclampsia and its subtypes
We found a decreased risk of EOPE associated with the second GWG quartile (OR = 0.30, 95%confidence intervals (CI): 0.10– 0.92), but this association was based on four exposed cases
Our study supported that pre-pregnancy overweight and excessive GWG were independently associated with an increased risk of preeclampsia and that the risk might vary by its clinical subtypes
Summary
To evaluate the independent and joint effects of maternal pre-pregnancy BMI and gestational weight gain (GWG) on the risk of preeclampsia and its subtypes. It affects up to 8% of all pregnancies worldwide and increases morbidity and mortality rates among both mothers and infants [2, 3]. The mortality rate among babies born to mothers with preeclampsia is five times higher than that among babies. A wide range of pregnancyspecific characteristics (e.g. parity, placental factors, multi-fetal gestation, and excessive weight gain during pregnancy) and pre-existing maternal features (e.g. age, race, pre-pregnancy overweight or obesity, pre-pregnancy diabetes, chronic hypertension etc.) are considered to be associated with preeclampsia [10]. Pre-pregnancy BMI and gestational weight gain (GWG) are two modifiable
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