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.
Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.
Research funding: We received no financial support and used no services from commercial organizations. The authors entirely did the study within the Division of Obstetrics and Gynecology, University Medical Centre, Ljubljana.
Employment or leadership: None declared.
Honorarium: None declared.
Disclosure of interest: The authors report no conflict of interest.
Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.
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Supplementary Material
The online version of this article offers supplementary material (https://doi.org/10.1515/jpm-2019-0008).
©2019 Walter de Gruyter GmbH, Berlin/Boston
Artikel in diesem Heft
- Frontmatter
- Review
- Placenta previa and the risk of intrauterine growth restriction (IUGR): a systematic review and meta-analysis
- Research Articles – Obstetrics
- 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
- Comparison of automated vs. manual measurement to estimate fetal weight in isolated polyhydramnios
- Strain and dyssynchrony in fetuses with congenital heart disease compared to normal controls using speckle tracking echocardiography (STE)
- Maternal abdominal subcutaneous fat thickness as a simple predictor for gestational diabetes mellitus
- Pregnancy outcome following bacteriuria in pregnancy and the significance of nitrites in urinalysis – a retrospective cohort study
- Nearly half of all severe fetal anomalies can be detected by first-trimester screening in experts’ hands
- Effect of maternal obesity on pregnancy outcomes in women delivering singleton babies: a historical cohort study
- Comparison of quantitative fluorescent polymerase chain reaction and karyotype analysis for prenatal screening of chromosomal aneuploidies in 270 amniotic fluid samples
- Effect of Sjögren’s syndrome on maternal and neonatal outcomes of pregnancy
- Intrapartum prediction of birth weight with a simplified algorithmic approach derived from maternal characteristics
- Efficacy of copy-number variation sequencing technology in prenatal diagnosis
- Socio-cultural and clinician determinants in the maternal decision-making process in the choice for trial of labor vs. elective repeated cesarean section: a questionnaire comparison between Italian settings
- Research Articles – Newborn
- Tidal volume monitoring during initial resuscitation of extremely prematurely born infants
- The level of extracellular superoxide dismutase in the first week of life in very and extremely low birth weight infants and the risk of developing bronchopulmonary dysplasia
- Effect of gender on growth-restricted fetuses born preterm
- Letters to the Editor
- Dermal bilirubin kinetics during phototherapy in term neonates
- Transcutaneous bilirubin to guide phototherapy: authors’ reply
Artikel in diesem Heft
- Frontmatter
- Review
- Placenta previa and the risk of intrauterine growth restriction (IUGR): a systematic review and meta-analysis
- Research Articles – Obstetrics
- 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
- Comparison of automated vs. manual measurement to estimate fetal weight in isolated polyhydramnios
- Strain and dyssynchrony in fetuses with congenital heart disease compared to normal controls using speckle tracking echocardiography (STE)
- Maternal abdominal subcutaneous fat thickness as a simple predictor for gestational diabetes mellitus
- Pregnancy outcome following bacteriuria in pregnancy and the significance of nitrites in urinalysis – a retrospective cohort study
- Nearly half of all severe fetal anomalies can be detected by first-trimester screening in experts’ hands
- Effect of maternal obesity on pregnancy outcomes in women delivering singleton babies: a historical cohort study
- Comparison of quantitative fluorescent polymerase chain reaction and karyotype analysis for prenatal screening of chromosomal aneuploidies in 270 amniotic fluid samples
- Effect of Sjögren’s syndrome on maternal and neonatal outcomes of pregnancy
- Intrapartum prediction of birth weight with a simplified algorithmic approach derived from maternal characteristics
- Efficacy of copy-number variation sequencing technology in prenatal diagnosis
- Socio-cultural and clinician determinants in the maternal decision-making process in the choice for trial of labor vs. elective repeated cesarean section: a questionnaire comparison between Italian settings
- Research Articles – Newborn
- Tidal volume monitoring during initial resuscitation of extremely prematurely born infants
- The level of extracellular superoxide dismutase in the first week of life in very and extremely low birth weight infants and the risk of developing bronchopulmonary dysplasia
- Effect of gender on growth-restricted fetuses born preterm
- Letters to the Editor
- Dermal bilirubin kinetics during phototherapy in term neonates
- Transcutaneous bilirubin to guide phototherapy: authors’ reply