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Delivery-to-delivery weight gain and risk of hypertensive disorders in a subsequent pregnancy

Obstetrics and Gynecology Sep 28, 2018

Dude AM, et al. - Researchers investigated the association between weight gain between deliveries and risk of hypertensive disorders in a subsequent pregnancy. Findings demonstrated an increase in body mass index (BMI) of at least 2 kg/m2 between deliveries was independently related to an increased risk of a hypertensive disorder in a subsequent pregnancy among women with no hypertensive disorder noted in an index pregnancy.

Methods

  • This is a case–control study.
  • Participants were women who had two live singleton births of at least 24 weeks of gestation at a single maternity hospital from January 1, 2005 to December 31, 2015, with no hypertensive disorder documented in the index pregnancy.
  • Researchers took note of the change in body mass index (BMI) at delivery, a measure for maternal weight gain between deliveries.
  • They used Χ2 statistics for categorical variables and t tests for continuous variables to compare women who were diagnosed with any hypertensive disorder in the subsequent pregnancy to those who experienced no hypertensive disorder in the subsequent pregnancy.
  • They also used logistic regression to investigate if weight gain remained independently related to hypertensive disorders after adjusting for potential confounders.

Results

  • A total of 188 (18.2%) of 1,033 women had a diagnosis of a hypertensive disorder in the subsequent pregnancy.
  • Of these, a hypertensive disorder specific to pregnancy (gestational hypertension; preeclampsia; superimposed preeclampsia; or hemolysis, elevated liver enzymes, and low platelet count syndrome) and chronic hypertension only was found in 166 (88.3%) and 22 (11.7%), respectively.
  • A significant association of greater weight gain between deliveries with a higher frequency of hypertensive disorders was observed, which continued to be significant for a BMI increase of at least 2 kg/m2 in multivariable analyses (adjusted odds ratio [OR] 1.76, 95% CI 1.14–2.74 for 2 to less than 4 kg/m2, adjusted OR 3.19, 95% CI 1.86–5.47 for 4 kg/m2 or more).
  • Conversely, a decreased risk of a hypertensive disorder was observed in relation to weight loss of 2 kg/m2 or more (adjusted OR 0.41, 95% CI 0.21–0.81).
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