Abstract
Early identification of high-risk pregnancies enables identification of those who would benefit from aspirin prophylaxis and increased surveillance for pre-eclampsia. A high body mass index (BMI) is a well-known predictor for pre-eclampsia. However, if abdominal adipose tissue distribution is associated with pre-eclampsia is limited investigated. Subcutaneous adipose tissue (SAT) thickness and visceral adipose tissue (VAT) thickness were measured by ultrasound on 3777 women at around 18 gestational weeks. SAT thickness was measured from the skin to linea alba and VAT from linea alba to the anterior aortic wall. The risk of developing pre-eclampsia (de novo hypertension at ≥ 20 gestational weeks in combination with proteinuria) was evaluated by logistic regression and expressed as odds ratio (OR) with 95% confidence intervals (CI). The risk of pre-eclampsia increased by 79% for every cm in SAT thickness (OR 1.79; 95% CI 1.48–2.17) and by 23% for every cm VAT thickness (OR 1.23; 95% CI 1.11–1.35). After adjustment for maternal age, parity, BMI, smoking and country of birth, the association between SAT thickness and pre-eclampsia remained (AOR 1.35; 95% CI 1.02–1.79). Greater SAT thickness measured with second trimester ultrasound is associated with increased risk of developing pre-eclampsia. The measurement may improve prediction models for pre-eclampsia.
Highlights
Identification of high-risk pregnancies enables identification of those who would benefit from aspirin prophylaxis and increased surveillance for pre-eclampsia
Women with pre-eclampsia gave birth to small for gestational age (SGA) infants more often compared to women without pre-eclampsia (6.8% vs. 0.8%), but no difference was found for giving birth to large for gestational age (LGA) infants. 55 women (1.5%) were treated with prophylactic aspirin
Our study shows that increased abdominal adipose tissue thickness in pregnancy is associated with development of pre-eclampsia
Summary
Identification of high-risk pregnancies enables identification of those who would benefit from aspirin prophylaxis and increased surveillance for pre-eclampsia. Subcutaneous adipose tissue (SAT) thickness and visceral adipose tissue (VAT) thickness were measured by ultrasound on 3777 women at around 18 gestational weeks. Studies on adipose tissue distribution in the general population show that both subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT) are associated with metabolic risk factors such as blood pressure, fasting plasma glucose, and high-density lipoprotein cholesterol[9,10]. Only three studies have investigated the association of abdominal adipose tissue distribution estimated by ultrasound and risk of hypertensive disorders in p regnancy[16,22,23], whereof only one studied pre-eclampsia s pecifically[23] and all study populations were comparatively small
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