Total gestational weight gain and the risk of preeclampsia by pre-pregnancy body mass index categories: a population-based cohort study from 2013 to 2017

Abstract

Background Identifying the risk factors for preeclampsia (PE) is essential for the implementation of preventive actions. In the present study, we aimed at exploring the association between total gestational weight gain (GWG) and PE. Methods We performed a population-based cohort survey of 98,820 women with singleton pregnancies who delivered in Slovenia from 2013 to 2017. Aggregated data were obtained from the National Perinatal Information System (NPIS). The main outcome measure was the incidence of PE. The main exposure variable was total GWG standardized for the gestational duration by calculating the z-scores. The associations between total GWG and PE stratified by pre-pregnancy body mass index (BMI) categories adjusted for a variety of covariates were determined using multivariable logistic regression. We calculated the crude odds ratio (OR) and adjusted odds ratio (aOR) with a 95% confidence interval using a two-way test. Results Excessive GWG was associated with increased odds of PE in all pre-pregnancy BMI categories. The increase in the odds of PE by 445% was the highest in underweight women and by 122% was the lowest in obese women. Low GWG was associated with decreased odds of PE in all pre-pregnancy BMI categories except in normal-weight women with a GWG below −2 standard deviation (SD) and underweight women. The decrease in the odds of PE by 67% was the highest in obese women and by 41% was the lowest in normal-weight women. Conclusion Excessive GWG is a significant risk factor for PE, especially in underweight women, while low GWG is an important protective factor against PE, especially in obese women.

Gestational weight gain and rate of late-onset preeclampsia: a retrospective analysis on 57 000 singleton pregnancies in Reunion Island

“…This study indicates that optimising GWG may represent an effective strategy to reduce the risk of LOP37. [17][18][19][20][21] Further research is urgently required to identify ways to assist women in achieving an optimal GWG, with randomised controlled trials to confirm that such intervention would translate our findings in a marked reduction in LOP rates.…”

Preterm delivery in infertile women after reproductive surgery: should we encourage spontaneous conception?

“…The mean gestational week at the first appointment in pregnancy was nine weeks. For the calculation of the GWG z-score, we used the same method as described before 13 . Preeclampsia was defined as the presence of hypertension (blood pressure [?…”

Adolphe Quetelet’s Premonition Two Centuries after: Besides Its Implications in Physiology (Obesity, Type 2 Diabetes), Its Paramount Importance in Human Pregnancy

“…After the Keys' description in 1972, interest for BMI in pregnancies (importantly: the maternal PRE-pregnancy BMI) seemed to appear in the beginning of the 1990's and we have witnessed since then a kind of explosion in terms of association with pregnancy risks [8][9][10][11][12]. There is a strong current ongoing consensus on obesity and consequences for maternal-fetal health, especially for example severe complications such as preeclampsia, not to speak of gestational diabetes mellitus and on the fetal sidel malformations, the risk of stillbirth and fetal overgrowth with as a result increased birthweights (notably the risk of macrosomic babies ≥ 4kg) [13][14][15].…”