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The impact of change in pregnancy body mass index on the development of gestational hypertensive disorders

Journal of Perinatology volume 34, pages 181–185 (2014)Cite this article

Subjects

Abstract

Objective:

To examine the impact of change in body mass index (BMI) during pregnancy on the incidence of gestational hypertension/preeclampsia.

Study Design:

This is a retrospective cohort study using linked California birth certificate and discharge diagnosis data from the year 2007. Adjusted odds ratios (aOR) and 95% confidence intervals (CI) were calculated for the outcome of gestational hypertension/preeclampsia, as a function of a categorical change in pregnancy BMI: BMI loss (<−0.5), no change (−0.5 to 0.5), minimal (0.6 to 5), moderate (5.1 to 10) and excessive (>10). The impact of change in pregnancy BMI was evaluated for the entire cohort and then as a function of prepregnancy BMI category. Women with no change in pregnancy BMI served as the reference group.

Result:

The study population consisted of 436 414 women with singleton gestations. Overall, women with excessive BMI change had a nearly twofold increased odds of gestational hypertension/preeclampsia (aOR=1.94; 95% CI=1.72 to 2.20). By prepregnancy BMI class, overweight and obese women who had a moderate change in pregnancy BMI also had increased odds of developing gestational hypertension/preeclampsia with aOR ranging from 1.73 to 1.97.

Conclusion:

Regardless of prepregnancy BMI category, women with excessive BMI change have a higher chance of developing gestational hypertension/preeclampsia. Overweight and obese women with moderate BMI change may also be at increased risk.

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Acknowledgements

This research was presented at the 33rd Annual Scientific Meeting of the Society for Maternal Fetal Medicine, San Francisco, CA, USA, 14 to 16 February 2013. This project was supported by Title V funds received from the California Department of Public Health: Maternal, Child, and Adolescent Health Division. Analysis, interpretation or conclusions reached are those of the authors and not the state of California. No financial support was received for this report. However, Title V funds were received from the California Department of Public Health: Maternal, Child, and Adolescent Health Division to develop the data set by the California Maternal Quality Care Collaborative.

Author information

Authors and Affiliations

  1. Department of Obstetrics and Gynecology, University of California Irvine Medical Center, Orange, CA, USA

    M L Swank, C K Farinelli & J H Chung

  2. Department of Obstetrics and Gynecology, Oregon Health and Science University, Portland, OR, USA

    A B Caughey

  3. California Maternal Quality Care Collaborative (CMQCC), Stanford, CA, USA

    E K Main & K A Melsop

  4. Department of Obstetrics and Gynecology, Sutter Medical Center, Sacramento, Sacramento, CA, USA

    W M Gilbert

Authors
  1. M L Swank
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  2. A B Caughey
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  3. C K Farinelli
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  4. E K Main
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  5. K A Melsop
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  6. W M Gilbert
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  7. J H Chung
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Corresponding author

Correspondence to J H Chung.

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Appendix I

Appendix I

Table a1 aOR for the development of gestational hypertension/preeclampsia as a function of change in BMI during pregnancy, accounting for prepregnancy BMI.*,†,‡,§
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Swank, M., Caughey, A., Farinelli, C. et al. The impact of change in pregnancy body mass index on the development of gestational hypertensive disorders. J Perinatol 34, 181–185 (2014). https://doi.org/10.1038/jp.2013.168

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