1. Maternal Adiposity and Energy Balance After Normotensive and Preeclamptic Pregnancies
- Author
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Melissa Ojurovic, Lynne Roberts, Anthony J O'Sullivan, Mark Brown, Sarah L McLennan, Amanda Henry, George Mangos, Amanda Yao, Franziska Pettit, Sai S Siritharan, and Gregory K. Davis
- Subjects
Adult ,medicine.medical_specialty ,Endocrinology, Diabetes and Metabolism ,Clinical Biochemistry ,Blood Pressure ,Biochemistry ,Preeclampsia ,preeclampsia ,Endocrinology ,Insulin resistance ,Pre-Eclampsia ,Pregnancy ,Internal medicine ,energy expenditure ,medicine ,Humans ,Online Only Articles ,Clinical Research Articles ,Adiposity ,business.industry ,Biochemistry (medical) ,Postpartum Period ,fat mass ,Anthropometry ,medicine.disease ,energy balance ,cardiovascular disease risk ,Cross-Sectional Studies ,energy intake ,Female ,Insulin Resistance ,business ,Complication ,Energy Metabolism ,Bioelectrical impedance analysis ,Postpartum period ,AcademicSubjects/MED00250 ,Lipoprotein - Abstract
Background Preeclampsia is a major pregnancy complication associated with long-term maternal cardiometabolic disease. Research generally is focused on metabolic and pathophysiological changes during pregnancy; however, there is much less focus on the early postpartum period in subjects who suffered preeclampsia. The aim of this study was to (1) characterize energy intake and expenditure 6 months following normotensive and preeclamptic pregnancies and (2) examine associations between energy balance, body composition, insulin resistance measures (HOMA-IR), and clinical characteristics. Design A cross-sectional study 6 months following normotensive (n = 75) and preeclamptic (n = 22) pregnancies was performed. Metabolic measurements included anthropometrics measures, body composition via bioelectrical impedance analysis, 24-h energy expenditure via SenseWear Armbands, energy intake via a 3-day food diary, and serum metabolic parameters. Results Six months following preeclampsia, women had a significantly higher weight (77.3 ± 20.9 kg vs 64.5 ± 11.4 kg, P = 0.01), fat mass percentage (FM%; 40.7 ± 7.4% vs 34.9 ± 8.1%, P = 0.004), and insulin resistance (HOMA-IR 2.2 ± 1.5 vs 1.0 ± 0.7, P = 0.003), as well as reduced HDL levels (1.5 ± 0.4 mmol/L vs 1.8 ± 0.4 mmol/L, P = 0.01) compared to normotensive women. Women post-preeclampsia had lower activity-related energy expenditure (P = 0.02) but a decreased total energy intake (P = 0.02), leading to a more negative energy balance compared to their normotensive counterparts (−1942 kJ/24 h vs −480 kJ/24 h, P = 0.02). Conclusion Increases in insulin resistance and FM%, reduced high-density lipoprotein, and more sedentary lifestyles characterize the postpartum period following preeclamptic compared with normotensive pregnancies. Early post-preeclampsia interventions, such as lifestyle behavior change, should be implemented and assessed to determine whether they reduce long-term cardiometabolic risk in women who experienced preeclampsia during pregnancy.
- Published
- 2021