As a result, identifying weight gain patterns before disease diagnosis has been difficult. Typically, only the woman’s final preeclampsia status at delivery is available. 16 Past findings, therefore, likely suffer from reverse causality (ie, higher weight gain is the result of, rather than a cause of, preeclampsia).Ī major challenge in overcoming bias because of reverse causation is that information on timing of preeclampsia onset is rarely available in population perinatal databases. This introduces a serious methodological flaw 15 because one of the symptoms of preeclampsia is edema, leading to higher weight gain because of water retention. 5 – 14 However, many of these studies only measured total pregnancy weight gain (ie, weight gain up to the time of delivery). Several studies have found that women with high pregnancy weight gain are more likely to develop pregnancy hypertensive disorders, including preeclampsia. Although prepregnancy obesity is a well-established modifiable risk factor for preeclampsia, 2 – 4 the role of high weight gain during pregnancy is less clear. 1 Identifying modifiable risk factors for preeclampsia is an important priority for preventing disease onset during pregnancy and potentially reducing longer-term health risks. Preeclampsia is a predictor of cardiovascular disease and other metabolic disorders in later life. In conclusion, high pregnancy weight gain before diagnosis increases the risk of preeclampsia in nulliparous women and is more strongly associated with later-onset preeclampsia than early-onset preeclampsia. By 25 weeks, the weight gain of women who subsequently developed preeclampsia was significantly higher than women who did not (eg, 0.43 kg in normal weight women). High pregnancy weight gain was more strongly associated with term preeclampsia than early preterm preeclampsia (eg, 64% versus 43% increased odds per 1 z score difference in weight gain in normal weight women, and 30% versus 0% in obese women, respectively). Odds of preeclampsia increased by ≈60% with every 1 z score increase in pregnancy weight gain among normal weight and overweight women and by 20% among obese women. Among 62 705 nulliparous women, 2770 (4.4%) developed preeclampsia. Antenatal weight gain measurements were standardized into gestational age-specific z scores. Electronic medical records were linked with population inpatient and outpatient records to establish date of preeclampsia diagnosis (classified as any, early preterm <34 weeks, late preterm 34–36 weeks, or term ≥37 weeks). The study population included nulliparous pregnant women in the Swedish counties of Gotland and Stockholm, 2008 to 2013, stratified by early pregnancy body mass index category. The aim of this study was to determine whether pregnancy weight gain before the diagnosis of preeclampsia is associated with increased risks of preeclampsia (overall and by preeclampsia subtype).
However, the consequences of weight gain throughout pregnancy up to the diagnosis of preeclampsia are unknown. Weight gain in early pregnancy may influence a woman’s risk of developing preeclampsia.
0 kommentar(er)
