Normal and High-Normal Blood Pressures, but Not Body Mass Index, Are Risk Factors for the Subsequent Occurrence of Both Preeclampsia and Gestational Hypertension: A Retrospective Cohort Study

Ohkuchi, Akihide; Iwasaki, Ryuhiko; Suzuki, Hiroyoshi; Hirashima, Chikako; Takahashi, Kei; Usui, Rie; Matsubara, Shigeki; Minakami, Hisanori; Suzuki, Mitsuaki

doi:10.1291/hypres.29.161

Cited by 55 publications

(46 citation statements)

References 20 publications

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“…A recent study suggested that obesity mostly increases the risk of gestational hypertension through higher blood pressure levels. 9 Our results indeed suggest that at least half the effect of overweight and obesity acts through relative increases in blood pressure early in pregnancy. In women with a mid-low education, relatively high blood pressure levels at enrolment further contributed independently of BMI to the explanation of their increased risk of developing gestational hypertension.…”

Section: Mediating Mechanismssupporting

confidence: 57%

“…33 Finally, we hypothesized that pre-existing diabetes, height and BMI at enrolment might influence gestational hypertension risk directly, or indirectly through blood pressure changes. 9 For the logistic hierarchical models, we started with model 1, then added smoking, alcohol consumption and illegal drug use (model 2). To this model, we then added pre-existent diabetes, height and BMI at enrolment (model 3).…”

Section: Age Graviditymentioning

confidence: 99%

“…9 Normal pregnancy is characterized by haemodynamic changes, which cause a steady decrease in blood pressure in the first half of pregnancy, followed by a rise in blood pressure in the second half until delivery. 40 It is plausible that the higher the blood pressure is at the start of pregnancy, the higher the blood pressure will be when haemodynamic demands increase in the second half of pregnancy, and the sooner blood pressure will cross the threshold level of hypertension.…”

Section: Mediating Mechanismsmentioning

confidence: 99%

“…2,9 In some studies, smoking during pregnancy has been associated with a lower risk of gestational hypertension. 10,11 Because low socioeconomic status is a marked risk factor for obesity, metabolic syndrome, hypertension and cardiovascular disease, [12][13][14] socioeconomic status is also likely to be associated with gestational hypertension.…”

Section: Introductionmentioning

confidence: 99%

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Maternal educational level and risk of gestational hypertension: the Generation R Study

et al. 2008

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We examined whether maternal educational level as an indicator of socioeconomic status is associated with gestational hypertension. We also examined the extent to which the effect of education is mediated by maternal substance use (that is smoking, alcohol consumption and illegal drug use), pre-existing diabetes, anthropometrics (that is height and body mass index (BMI)) and blood pressure at enrolment. This was studied in 3262 Dutch pregnant women participating in the Generation R Study, a population-based cohort study. Level of maternal education was established by questionnaire at enrolment, and categorized into high, mid-high, mid-low and low. Diagnosis of gestational hypertension was retrieved from medical records using standard criteria. Odds ratios (OR) of gestational hypertension for educational levels were calculated, adjusted for potential confounders and additionally adjusted for potential mediators. Adjusted for age and gravidity, women with mid-low (OR: 1.52; 95% CI: 1.02, 2.27) and low education (OR: 1.30; 95% CI: 0.80, 2.12) had a higher risk of gestational hypertension than women with high education. Additional adjustment for substance use, pre-existing diabetes, anthropometrics and blood pressure at enrolment attenuated these ORs to 1.09 (95% CI: 0.70, 1.69) and 0.89 (95% CI: 0.50, 1.58), respectively. These attenuations were largely due to the effects of BMI and blood pressure at enrolment. Women with relatively low educational levels have a higher risk of gestational hypertension, which is largely due to higher BMI and blood pressure levels from early pregnancy. The higher risk of gestational hypertension in these women is probably caused by pre-existing hypertensive tendencies that manifested themselves during pregnancy.

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Section: Mediating Mechanismssupporting

confidence: 57%

Section: Age Graviditymentioning

confidence: 99%

Section: Mediating Mechanismsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Maternal educational level and risk of gestational hypertension: the Generation R Study

et al. 2008

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“…However, in some studies, obesity was not identified as an independent risk factor but was rather associated with race, showing that non-Hispanic white obese women had a higher risk for PE when compared to black, Asian and white Hispanic obese women 28,29 .…”

Section: Discussionmentioning

confidence: 99%

Estudo dos principais fatores de risco maternos nas síndromes hipertensivas da gestação

Assis¹,

Viana²,

Rassi³

2008

Arq. Bras. Cardiol.

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Development of preeclampsia in pregnant women with white-coat hypertension: a systematic review and meta-analysis

Hadizadeh,

Shahmohamadi,

Khezerlouy-Aghdam

et al. 2023

Arch Gynecol Obstet

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Normal and High-Normal Blood Pressures, but Not Body Mass Index, Are Risk Factors for the Subsequent Occurrence of Both Preeclampsia and Gestational Hypertension: A Retrospective Cohort Study

Cited by 55 publications

References 20 publications

Maternal educational level and risk of gestational hypertension: the Generation R Study

Maternal educational level and risk of gestational hypertension: the Generation R Study

Estudo dos principais fatores de risco maternos nas síndromes hipertensivas da gestação

Development of preeclampsia in pregnant women with white-coat hypertension: a systematic review and meta-analysis

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