Abstract
Objective
To identify clinical and biomarker risk factors for preeclampsia in women with obesity and to explore interactions with gestational diabetes, a condition associated with preeclampsia.
Study Design
In women with obesity (body mass index ≥30 kg/m2) from the UK Pregnancies Better Eating and Activity Trial (UPBEAT), we examined 8 clinical factors (socio-demographic characteristics, BMI, waist circumference and clinical variables) and 7 biomarkers (HDL cholesterol, hemoglobin A1c, adiponectin, interleukin-6, high sensitivity C-reactive protein, and placental growth factor (PlGF)) in the early second trimester for association with later development of preeclampsia using logistic regression. Factors were selected based on prior association with preeclampsia. Interaction with gestational diabetes was assessed.
Main outcome measure
Preeclampsia.
Results
Prevalence of preeclampsia was 7.3% (59/824). Factors independently associated with preeclampsia were higher mean arterial blood pressure (Odds Ratio (OR) 2.22; 95% Confidence Interval (CI) 1.58 to 3.12, per 10 mmHg) and lower PlGF (OR 1.39; 95% CI 1.03 to 1.87, per each lower 1 log2). The association of PlGF with preeclampsia was present amongst obese women without gestational diabetes (OR 1.91; 95% CI 1.32 to 2.78), but not in those with GDM (OR 1.05; 95% CI 0.67 to 1.63), p=0.04 for interaction.
Conclusion
The relationship between PlGF and preeclampsia differed in women with obesity according to gestational diabetes status, which may suggest different mechanistic pathways to preeclampsia. Whilst replication is required in other populations, this study suggests that performance of prediction models for preeclampsia should be confirmed in pre-specified subgroups.
Abbreviations
BMIbody mass indexFDRFalse discovery rateGDMgestational diabetes mellitusHbA1chemoglobin A1cHDLhigh density lipoproteinHs-CRPhigh sensitivity C Reactive ProteinIL-6interleukin-6OGTToral glucose tolerance testPlGFplacental growth factorsFlt-1soluble VEGF receptorVEGFvascular endothelial growth factor
To identify clinical and biomarker risk factors for preeclampsia in women with obesity and to explore interactions with gestational diabetes, a condition associated with preeclampsia.
Study Design
In women with obesity (body mass index ≥30 kg/m2) from the UK Pregnancies Better Eating and Activity Trial (UPBEAT), we examined 8 clinical factors (socio-demographic characteristics, BMI, waist circumference and clinical variables) and 7 biomarkers (HDL cholesterol, hemoglobin A1c, adiponectin, interleukin-6, high sensitivity C-reactive protein, and placental growth factor (PlGF)) in the early second trimester for association with later development of preeclampsia using logistic regression. Factors were selected based on prior association with preeclampsia. Interaction with gestational diabetes was assessed.
Main outcome measure
Preeclampsia.
Results
Prevalence of preeclampsia was 7.3% (59/824). Factors independently associated with preeclampsia were higher mean arterial blood pressure (Odds Ratio (OR) 2.22; 95% Confidence Interval (CI) 1.58 to 3.12, per 10 mmHg) and lower PlGF (OR 1.39; 95% CI 1.03 to 1.87, per each lower 1 log2). The association of PlGF with preeclampsia was present amongst obese women without gestational diabetes (OR 1.91; 95% CI 1.32 to 2.78), but not in those with GDM (OR 1.05; 95% CI 0.67 to 1.63), p=0.04 for interaction.
Conclusion
The relationship between PlGF and preeclampsia differed in women with obesity according to gestational diabetes status, which may suggest different mechanistic pathways to preeclampsia. Whilst replication is required in other populations, this study suggests that performance of prediction models for preeclampsia should be confirmed in pre-specified subgroups.
Abbreviations
BMIbody mass indexFDRFalse discovery rateGDMgestational diabetes mellitusHbA1chemoglobin A1cHDLhigh density lipoproteinHs-CRPhigh sensitivity C Reactive ProteinIL-6interleukin-6OGTToral glucose tolerance testPlGFplacental growth factorsFlt-1soluble VEGF receptorVEGFvascular endothelial growth factor
Original language | English |
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Pages (from-to) | 267-272 |
Journal | Pregnancy Hypertension: An International Journal of Women's Cardiovascular Health |
Volume | 13 |
Early online date | 10 Jul 2018 |
DOIs | |
Publication status | Published - Jul 2018 |
Keywords
- Obesity
- Preeclampsia
- Gestational diabetes mellitus
- Risk factors
- Biomarkers