Weight gain velocity in relation to the development of gestational hypertension and or preeclampsia

Risk of preeclampsia by gestational weight gain in women with varied prepregnancy BMI: A retrospective cohort study

INTRODUCTION

Despite the important clinical significance, limited data on the joint contribution of prepregnancy body mass index (BMI) and gestational weight gain (GWG) to preeclampsia, the second leading cause of maternal mortality worldwide. This study aimed to estimate the risk of preeclampsia by GWG among women with varied prepregnancy BMI.

METHODS

We conducted a retrospective cohort study using data of 117 738 singleton pregnant women aged 18-49 years from 150 maternity hospitals in China between 2015 and 2018. GWG was calculated as the measured weight at the time of preeclampsia assessment minus prepregnancy weight; GWG velocity was calculated as the GWG divided by the gestational age at weighing. The non-linear associations of GWG with preeclampsia were examined by restricted cubic spline regression analysis according to prepregnancy BMI. The association of the GWG categories with preeclampsia was further examined by performing robust Poisson regression stratified by the prepregnancy BMI categories.

RESULTS

Among participants, 2426 (2.06%) were diagnosed with preeclampsia. Compared to women with normal BMI, those who were overweight and obese had 1.92- fold (95%CI, 1.73-2.14) and 5.06- fold (95%CI, 4.43-5.78) increased risks for preeclampsia, respectively. The association of GWG velocity with preeclampsia was presented as a J-shaped curve with the varied inflexion point (where the rate of preeclampsia was 2%), which was 0.54, 0.38, and 0.25 kg/week in women with normal BMI, overweight, and obesity, respectively; a steep risk rise was observed along with GWG velocity beyond the inflexion points. The overall adjusted relative risk for preeclampsia was calculated among women with the different GWG categories of GWG.

CONCLUSIONS

The findings highlight that high prepregnancy BMI and exceed GWG contributed to increased risk of preeclampsia with a superimposed effect and underscore the need to optimize the recommendations for GWG for women with different prepregnancy BMI.

Nutritional status of women with gestational hypertension compared with normal pregnant women

BACKGROUND

Some evidence indicated the role of nutrition in the development of hypertensive disorders of pregnancy.

METHODS

This case-control study was conducted on 113 women with gestational hypertension and 150 healthy pregnant women referred to Shahid Akbarabadi Hospital in Tehran. A demographic questionnaire was filled out for all participants. A validated semi-quantitative food frequency questionnaire was used to assess the dietary intakes of the study subjects. All nutrients were adjusted for total energy intake. Logistic regression was used to find the association of energy and nutrient intakes with gestational hypertension.

RESULTS

We found that higher intakes of energy (OR, 1.33; 95% CI: 1.17-1.52), monounsaturated fatty acids (OR, 1.34; 95% CI: 1.03-1.74) and polyunsaturated fatty acids (OR, 1.26; 95% CI: 1.00-1.54) were positively associated with the risk of gestational hypertension after adjustment for confounders. We also observed decreased odds of gestational hypertension with increased intakes of vitamin C (OR, 0.87; 95% CI: 0.81-0.94), potassium (OR, 0.45; 95% CI: 0.28-0.71) and magnesium (OR, 0.68; 95% CI: 0.51-0.89).

CONCLUSION

This study demonstrates higher intakes of energy, monounsaturated fatty acids and polyunsaturated fatty acids as well as lower intakes of vitamin C, potassium and magnesium are positively correlated with the risk of developing gestational hypertension.