Prevalence of metabolic syndrome in preeclampsia

Abstract

INTRODUCTIONPre-eclampsia is defined as new onset of hypertension and proteinuria after 20th weeks of gestation in a previously normotensive woman and it complicates 2-8% of pregnancies and contributes to considerable maternal, neonatal morbidity and mortality.1-3 The majority of maternal deaths during pregnancy are caused by medical disorders and hypertension being the commonest cause. 4 The aetiology of preeclampsia remains unknown despite continued medical research. The pathophysiology of preeclampsia likely involves both maternal and fetal/placental factors although more with the former.The risk of abnormal placentation and preeclampsia is the result of medical conditions associated with vascular ABSTRACT Background: Preeclampsia is associated with increased morbidity and mortality and it increases with severity of preeclampsia. Preeclampsia shares many characteristics of metabolic syndrome (MeS) which has led many investigators to elucidate this relationship. The aim and objective of this study was to assess the prevalence of MS in preeclampsia and its relation with its severity. Methods: The study included 130 cases (41 gestational hypertension (GHTN), 27 mild pre-eclampsia (Mild PET), 47 severe preeclampsia (Severe PET), 13 pre-eclampsia superimposed on chronic hypertension (PSHTN) and 2 eclampsia) based on pre-specified maternal characteristics according to ACOG criteria after 20 th week of gestation. Two hundred normotensive pregnant females served as controls. The frequency of MS was assessed using pregnancy adaptation of MeS definition of the NCEP-ATP III criteria in cases and controls. Results: Metabolic syndrome was found in 37.7% of preeclampsia group and 12% of control group (p<0.00). Among the components of MeS, preeclampsia group was having significantly higher sugars (30% Vs 20%) and body mass index (BMI) (23.8% Vs 7.5%) than controls. GHTN was seen in 31.5%, mild PET in 20.8%, severe PET in 36.2%, PSHTN in 10% and eclampsia in 1.5% of cases. MeS was seen in 57.4% of severe PET, 50% of eclampsia, 26.8% of GHTN, 25.9% of mild PET and 23.1% of PSHTN. The clinical course in preeclampsia with MeS was complicated by IUD (intrauterine death), IUGR (intrauterine growth retardation), preterm delivery, APH and pulmonary edema. Oligohydromnios was less common in preeclampsia with MeS. Conclusions: The frequency of MeS was higher in preeclampsia group as compared to normotensive group. MeS was more significantly higher in patients with severe preeclampsia. In our study there were no demographic, clinical and laboratory predictors of MeS in preeclampsia. On the other hand, preeclampsia patients with MeS had significant maternofoetal complications. There is a need to screen for MeS in pregnant females from the first antenatal visit in order to predict severe preeclampsia.

Prevalence and associated factors of metabolic syndrome among pregnant Ethiopian women: a hospital-based cross-sectional study

“…According to the American Heart Association/ National Heart Lung and Blood Institute (AHA/NHLBI) definition, the overall prevalence of MetS in the present study was 13.2% (95% CI (9.7–17.0)). This study aligns with the reported prevalence in Angola (12.6%) 5 , India (12%) 6 , and a multi-center study conducted in New Zealand, Australia and UK (12.4% and 12.3%) 7 , 8 . However, the prevalence observed in the current study is higher than that reported in studies conducted in Cameroon (7%) 9 , Brazil (3%) 10 , India (8%) 11 , and Sri Lanka (5.6%, 5.4%, 4.2%, and 3% based on AHA/NHLBI, IDF, NCEP-ATP III, and WHO diagnosis criteria, respectively) 12 .…”

“…Additionally, genetic, ethnic, and lifestyle factors may contribute to the observed differences in prevalence. The prevalence of elevated DBP/SBP in this study was 18.3%, which was almost consistent report in India (20.5%) 6 .While the current study was lower as compared to the reports in Angola (29.5%) 5 . While a higher prevalence of elevated BP was obtained in the current study as compared to the study done in Sri Lanka (2.3%) 19 , a multi-center study in Australia, New Zealand, and UK (3.69%, 3.65%) (45, 46).…”

“…This study was almost similar with the reports in Brazil (31.5%) 10 , a multicenter study in Australia, New Zealand and UK (29.15%) and Angola (28.99%) 5 , 8 . However, the current study was lower than the findings reported in India (55%, 44%) 6 , 11 and higher than other studies done in Cameroon (3.7%) 9 , Sri Lanka (6.9%) 12 and a multi-center study in Australia, New Zealand, and UK (24.52%, 25%) 7 , 14 . The observed discrepancy could be linked to variations in lifestyle factors, ethnicity, genetic influences, and differences in gestational age.…”

“…The current finding was lower as compared to the studies reported in Cameroon (66%) 13 , India (56%) 11 and Sri Lanka (52.5%) 12 . Conversely, it was higher compared to results in Angola (11.9%) 5 , Cameroon (16.3%) 9 , India www.nature.com/scientificreports/ (23%) 6 , and a multi-center study in Australia, New Zealand, and UK) (5.6%, 19.61%, 11.58%) 7,8,14 . The variation may be attributed to differences in gestational age, as HDL concentration tends to decrease with advancing pregnancy 16 .…”

“…Pregnancy is a risk factor for the development of MetS. This is a period of weight gain, hyperlipidemia, and insulin resistance 6 . This period induces substantial metabolic and hemodynamic shifts in a woman's physiology to support fetal growth.…”