Effects of nulliparity, maternal age, and pre-pregnancy body mass index on the development of gestational hypertension and preeclampsia

Abstract

Aims:We aimed to determine the effects of nulliparity, maternal age, and pre-pregnancy body mass index (BMI, kg / m 2 ) on the development of pregnancy induced hypertension (PIH) in Japanese women, including gestational hypertension (GH) and preeclampsia (PE). Methods: Data on 138,530 women with singleton pregnancies who were registered with the Japan Society of Obstetrics and Gynecology and gave birth at ≥ 22 weeks of gestation during the three years from 2007 and 2009 were analyzed. Results: PIH was diagnosed in 6,578 (4.7%) women, including 3,326 (2.4%) with GH and 3,252 (2.3%) with PE. PIH was more frequent in nulliparous than multiparous women (relative risk [95% confidence interval], 1.30 [1.24 to 1.37]) and increased linearly with advancing maternal age after 35 years and also with increasing pre-pregnancy BMI. PIH also varied greatly among 24 groups stratified according to 4 maternal age categories and 6 pre-pregnancy BMI categories, with the lowest frequency (2.7%) among lean (BMI < 18.5) women 20-34 years of age and the highest frequency (21.7%) among obese (BMI ≥ 30) women ≥ 40 years of age. Conclusions: Our findings provide useful information for counseling Japanese women about the risk of PIH at the beginning of pregnancy.

Extraordinary weight gain: initial finding in a patient with peripartum cardiomyopathy

“…We speculate that such women with extreme antenatal weight gain are at higher risk of developing PPCM based on our case. Our speculation was consistent with results of previous studies that a greater weight gain in pregnancy is associated with the development of preeclampsia [10] and women with preeclampsia are at higher risk of developing PPCM [1,2,3,4,5].…”

Second-trimester urine nephrin:creatinine ratio versus soluble fms-like tyrosine kinase-1:placental growth factor ratio for prediction of preeclampsia among asymptomatic women

“…As our institution is a tertiary centre managing mainly women at higher risk, the frequency of PE (5.9%, 15/254) in this study was somewhat higher than the prevalence rate of 2.3% in the general Japanese population27. The number of women aged ≥35 years (44% [112/254)), with twin pregnancies (13% [32/254]), and with complications including DM/GDM and connective tissue diseases (approximately 20%) were greater in this study than in the general population.…”

“…The number of women aged ≥35 years (44% [112/254)), with twin pregnancies (13% [32/254]), and with complications including DM/GDM and connective tissue diseases (approximately 20%) were greater in this study than in the general population. As all of these are risk factors for PE272829, this observation explained the somewhat higher frequency of PE in this study, and therefore our study population did not represent the general population.…”

Gestational Weight Gain in a Woman with Peripartum Cardiomyopathy

“…Cardiac biomarkers, such as NT-proBNP and high-sensitive troponin I (TnI), increase significantly during the late stage of pregnancy even in uncomplicated pregnancies, especially in women with well-known risk factors for PPCM, such as preeclampsia and multifetal pregnancy [17]. Both pre-eclampsia and multifetal pregnancy are associated with greater GWG [13,18]. Patients diagnosed with PPCM exhibit high levels of both NT-proBNP and TnI when tested [19].…”