Weight Retention and Risk of Pregnancy-Associated Hypertension in Subsequent Pregnancy [40D

Abstract

INTRODUCTION: We sought to examine the rate of pregnancy-associated hypertension according to weight gain between pregnancies among obese women. METHODS: This was a retrospective cohort study of all women who had at least two pregnancies at 23 weeks' gestation or greater at a single academic institution. Women with prepregnancy body mass index (BMI kg/m2) less than 30 kg/m2 in the first pregnancy, a history of chronic hypertension, or pregestational diabetes in the first pregnancy were excluded. Women were stratified based on weight change between pregnancies. Our primary outcome was the rate of pregnancy-associated hypertension (gestational hypertension or preeclampsia). A multivariable logistic regression analysis was performed to calculate adjusted odds ratios (OR) and 95% confidence intervals (95% CI), controlling for predefined covariates. RESULTS: Of 1,046 women, 248 (23.7%), 453 (43.3%), and 345 (33.0%) had weight loss (BMI>2 kg/m2), stable weight (BMI change -2 to +2 kg/m2), and weight gain (BMI>2 kg/m2), respectively. Women with weight gain compared to those with stable weight were more likely to have pregnancy-associated hypertension (14.5% vs. 7.1%; adjusted OR 1.96 [95% CI 1.20–3.22]). Women with weight loss compared to those with stable weight had a similar rate of pregnancy-associated hypertension (2.1% vs. 7.1%; adjusted OR 0.96 [95% CI 0.52–1.78]). CONCLUSION: In our cohort of obese multiparous women, weight gain was associated with increased odds of pregnancy-associated hypertension compared to a stable weight.