Pre-pregnancy BMI, gestational weight gain and risk of preeclampsia: a birth cohort study in Lanzhou, China

Shao, Yawen; Qiu, Jie; Huang, Huang; Mao, Baohong; Dai, Wei; He, Xiaoxuan; Cui, Hongmei; Lin, Xiaojuan; Lv, Ling; Wang, Dennis; Tang, Zhongfeng; Xu, Sijuan; Zhao, Nan; Zhou, Min; Xu, Xiaoying; Qiu, Weitao; Liu, Qing; Zhang, Yawei

doi:10.1186/s12884-017-1567-2

Cited by 86 publications

(110 citation statements)

References 69 publications

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“…Our findings regarding associations between GWG and preeclampsia are in line with several other studies [ 6 , 7 , 9 ], although there is still conflicting evidence [ 10 , 11 ]. Underlying mechanisms for a potential causal association between weight gain per se and preeclampsia could be that excessive GWG may increase oxidative stress, and thereby stimulate or aggravate a systemic inflammatory response which could accelerate damage to vascular endothelial cells leading to preeclampsia [ 15 ].…”

Section: Main Textsupporting

confidence: 92%

“…A leading hypothesis is placental dysfunction from early pregnancy [ 5 ] that leads to placental ischemia and an exaggerated maternal systemic inflammatory reaction to pregnancy. Maternal gestational weight gain (GWG) has received attention as a potentially modifiable risk factor for preeclampsia, however the results are inconclusive, with some studies suggesting an association [ 6 – 9 ] and others not [ 10 , 11 ]. The fact that gestational weight gain (GWG) is a composite of fat mass, fat-free mass, and extracellular fluid accrual complicates the interpretation of these observations.…”

Section: Introductionmentioning

confidence: 99%

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Preeclampsia and gestational weight gain in the Norwegian Fit for Delivery trial

et al. 2018

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ObjectiveExcessive gestational weight gain is linked to risk of preeclampsia, but it is not clear whether the association is causal. The purpose of this paper was to examine gestational weight gain in the Norwegian Fit for Delivery study among women who developed preeclampsia compared to those who did not, and to further explore associations between weight gain and preeclampsia by including data on body composition (bioimpedance) assessed in the last trimester of pregnancy.ResultsA total of 550 women were eligible for the study. Women who developed preeclampsia gained more weight than women who did not (difference 3.7 kg, p = 0.004), with a 3.5 kg difference in total body water observed in week 36 (p = 0.040). Adjusted for age, education, pre-pregnancy body mass index (BMI), randomization, and fat mass, a one kg increase in GWG was associated with 1.3 times higher odds of preeclampsia (OR: 1.31, 95% CI 1.15–1.49, p < 0.001). An independent inverse association between fat mass in week 36 and odds of preeclampsia was observed (OR: 0.79, 95% CI 0.68–0.92, p = 0.002). Given the observed difference in total body water, these findings point to excess fluid as the component driving the association between gestational weight gain and preeclampsia in the present study.Trial registration The NFFD trial has the Clinical Trials registration: clinicaltrial.gov NCT0100168

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Section: Main Textsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Preeclampsia and gestational weight gain in the Norwegian Fit for Delivery trial

et al. 2018

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“…In contrast, weight retention during the post‐partum period was associated with accelerations in DNA methylation age and higher PEAA at 12 months post‐partum, and this was independent of weight change during pregnancy. These findings are important in the context of prior work suggesting that post‐partum weight gain and weight retention increases risk for later health issues …”

Section: Discussionmentioning

confidence: 64%

Immune epigenetic age in pregnancy and 1 year after birth: Associations with weight change

Ross

Carroll

Horvath

et al. 2020

American J Rep Immunol

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Problem Epigenetic age indices are markers of biological aging determined from DNA methylation patterns. Accelerated epigenetic age predicts morbidity and mortality. Women tend to demonstrate slower blood epigenetic aging compared to men, possibly due to female‐specific hormones and reproductive milestones. Pregnancy and the post‐partum period are critical reproductive periods that have not been studied yet with respect to epigenetic aging. The purpose of this paper was to examine whether pregnancy itself and an important pregnancy‐related variable, changes in body mass index (BMI) between pregnancy and the post‐partum period, are associated with epigenetic aging. Method of Study A pilot sample of 35 women was recruited as part of the Healthy Babies Before Birth (HB3) project. Whole blood samples were collected at mid‐pregnancy and 1 year post‐partum. DNA methylation at both time points was assayed using Infinium 450K and EPIC chips. Epigenetic age indices were calculated using an online calculator. Results Paired‐sample t‐tests were used to test differences in epigenetic age indices from pregnancy to 1 year after birth. Over this critical time span, women became younger with respect to phenotypic epigenetic age, GrimAge, DNAm PAI‐1, and epigenetic age indices linked to aging‐related shifts in immune cell populations, known as extrinsic epigenetic age. Post‐partum BMI retention, but not prenatal BMI increases, predicted accelerated epigenetic aging. Conclusion Women appear to become younger from pregnancy to the post‐partum period based on specific epigenetic age indices. Further, BMI at 1 year after birth that reflects weight retention predicted greater epigenetic aging during this period.

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“…Therefore, the importance of nutrition in pregnancy cannot be overemphasized. Previous studies have proved that excessive or inadequate weight gain during pregnancy has negative implications on pregnancy outcomes, putting the health of both mother and infant at risk [ 2 – 4 ].…”

Section: Introductionmentioning

confidence: 99%

Gestational weight gain in Chinese women -- results from a retrospective cohort in Changsha, China

Huang

Tan

Cai

et al. 2018

BMC Pregnancy Childbirth

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BackgroundThe generalizability of the gestational weight gain (GWG) ranges recommended by the Institute of Medicine (IOM) to Chinese women is disputed.MethodsIn 2016, 16,780 pregnant women who gave birth to live singletons in Changsha, China, were enrolled. First, subjects with optimal pregnancy outcomes were identified for the GWG percentile distribution description and for comparison to the IOM recommendations. Second, all subjects with optimal GWG according to the IOM body mass index (BMI) cutoffs and those with optimal GWG according to the Asian BMI cutoffs were selected. Pregnancy outcomes were compared between those two groups.ResultsA total of 13,717 births with optimal pregnancy outcomes were selected to describe the GWG distribution. The height and central position of the GWG distributions determined by the Asian BMI cutoffs differed from those determined by the IOM BMI cutoffs among the overweight and obese groups. The recommended IOM GWG ranges were narrower than and shifted to the left of the observed distributions. In both BMI classification schemes, however, the IOM-recommended ranges were within the middle 70% (Pc 15th–85th) and 50% (Pc 25th–75th) of the observed distribution. A total of 6438 (38.37%) and 6110 (36.41%) women gained optimal GWG, according to the IOM and Asian BMI classifications, respectively. Compared with those with optimal GWG according to IOM BMI cutoffs, women with optimal GWG according to the Asian BMI cutoffs had lower risks of both macrosomia (adjusted OR = 0.79, 95%CI: 0.67–0.94) and large-for-gestational age (adjusted OR = 0.86, 95%CI: 0.76, 0.98). However, no significantly different risks of preterm, low birthweight, small-for-gestational age, pregnancy-induced hypertension, or gestational diabetes were found between them.ConclusionsThe IOM-recommended GWG ranges are within the middle 70% of the distributions in Chinese women, and pre-pregnancy weight status should be determined by the Asian BMI cut-off points for monitoring and making GWG recommendations to Chinese women.Electronic supplementary materialThe online version of this article (10.1186/s12884-018-1833-y) contains supplementary material, which is available to authorized users.

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Pre-pregnancy BMI, gestational weight gain and risk of preeclampsia: a birth cohort study in Lanzhou, China

Cited by 86 publications

References 69 publications

Preeclampsia and gestational weight gain in the Norwegian Fit for Delivery trial

Preeclampsia and gestational weight gain in the Norwegian Fit for Delivery trial

Immune epigenetic age in pregnancy and 1 year after birth: Associations with weight change

Gestational weight gain in Chinese women -- results from a retrospective cohort in Changsha, China

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