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Early-pregnancy weight gain and the risk of preeclampsia: A case-cohort study.
- Source :
-
Pregnancy hypertension [Pregnancy Hypertens] 2018 Oct; Vol. 14, pp. 205-212. Date of Electronic Publication: 2018 Oct 15. - Publication Year :
- 2018
-
Abstract
- Objective: To investigate the association between early-pregnancy weight gain and risk of preeclampsia to inform pregnancy weight gain recommendations.<br />Study Design: We performed a case-cohort study using a hospital database including 80,812 singleton deliveries from Magee-Womens Hospital, Pittsburgh, Pennsylvania (1998-2011). In each of 6 prepregnancy body mass index (BMI) groups, we abstracted serial antenatal weight measurements from the records of up to 339 preeclampsia cases and 1254 randomly selected pregnancies. Early gestational weight gain (16-19 weeks' gestation) was standardized for gestational duration using BMI-specific z-score charts. Multivariable log-binomial regression was used to assess the association between weight gain z-score and risk of preeclampsia. We determined the impact of preeclampsia misclassification using probabilistic bias analysis.<br />Main Outcome Measure: Risk of preeclampsia.<br />Results: For normal weight women, there was a steady increase in preeclampsia risk with increasing early gestational weight gain z-score. For example, compared with a weight gain of 1.2 kg (z-score = -1 SD), a 7.2-kg weight gain (z-score = +1 SD) at 16 weeks was associated with 1.3 (0.50, 2.2) excess preeclampsia cases per 100 deliveries. Weight loss at 16-19 weeks among grade 2 or 3 obese women was associated with a reduced risk of preeclampsia. Associations were null among overweight and grade 1 obese women. The bias analysis supported the validity of the conventional analysis.<br />Conclusions: Early-pregnancy weight gain may be associated with preeclampsia in some BMI groups. Future revisions of pregnancy weight gain recommendations should account for preeclampsia risks from this and additional studies.<br /> (Copyright © 2018 International Society for the Study of Hypertension in Pregnancy. Published by Elsevier B.V. All rights reserved.)
Details
- Language :
- English
- ISSN :
- 2210-7797
- Volume :
- 14
- Database :
- MEDLINE
- Journal :
- Pregnancy hypertension
- Publication Type :
- Academic Journal
- Accession number :
- 30527113
- Full Text :
- https://doi.org/10.1016/j.preghy.2018.10.005