Degree of obesity at delivery and risk of preeclampsia with severe features
| Autor: | Jennifer K. Durst, Molly J. Stout, Alison G. Cahill, Methodius G. Tuuli, George A. Macones |
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| Rok vydání: | 2015 |
| Předmět: |
Adult
Pediatrics medicine.medical_specialty Gestational Age macromolecular substances Disease Overweight Severity of Illness Index Preeclampsia Body Mass Index Cohort Studies 03 medical and health sciences Young Adult 0302 clinical medicine Pre-Eclampsia Pregnancy medicine Humans Mass index 030212 general & internal medicine Obesity reproductive and urinary physiology Retrospective Studies 030219 obstetrics & reproductive medicine business.industry nutritional and metabolic diseases Obstetrics and Gynecology Retrospective cohort study medicine.disease Delivery Obstetric female genital diseases and pregnancy complications embryonic structures Cohort Premature Birth Female medicine.symptom business Live birth |
| Zdroj: | American journal of obstetrics and gynecology. 214(5) |
| ISSN: | 1097-6868 |
| Popis: | The risk of preeclampsia increases as maternal body mass index (BMI) increases. The link between increasing maternal BMI and preeclampsia with severe features is less well-established.To estimate the effect of increasing severity of obesity on risk of preeclampsia with severe features, stratified by early-onset and late-onset disease.We performed a retrospective cohort study of consecutive singleton live births at a tertiary care facility from 2004 to 2008. Women were included in the cohort if they delivered a singleton live birth and maternal height and weight was measured on admission. The primary exposure was maternal weight category on presentation for delivery, defined as normal (BMI 18.5-24.9; referent group, n = 1473), overweight (BMI 25-29.9, n = 3081), obese (BMI 30-39.9, n = 4196), and morbidly obese (BMI ≥40, n = 1446). The primary outcome was preeclampsia with severe features. Secondary outcome was early-onset preeclampsia with severe features at34 weeks or late-onset preeclampsia with severe features at ≥34 weeks. Multivariable logistic regression was used to adjust for confounders.Of the 10,196 patients meeting inclusion criteria, 1119 developed preeclampsia. Of those, 881 (8.6%) women developed preeclampsia with severe features. Overall, the risk of preeclampsia with severe features was not significantly different in the 4 BMI categories. Of the 10,196 women in the cohort, 1072 delivered34 weeks and 9124 delivered ≥34 weeks. When stratifying by gestational age at delivery, there was a statistically significant increased risk of developing late-onset preeclampsia with severe features at ≥34 weeks in overweight (4.5%, adjusted odds ratio [aOR] 1.4, 95% confidence interval [CI] 1.0-2.1), obese (6.2%, aOR 2.0, 95% CI 1.4-2.8) and morbidly obese (6.8%, aOR 2.0, 95% CI 1.3-2.9) women compared with normal-weight women (2.9%).Increasing maternal weight was not associated with preeclampsia with severe features in the total cohort; however, overweight, obese, and morbidly obese women are at increased risk of developing late-onset preeclampsia with severe features. |
| Databáze: | OpenAIRE |
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