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Primary preeclampsia in the second pregnancy: effects of changes in prepregnancy body mass index between pregnancies.
Obstet Gynecol 2007; 110(6):1319-25OG

Abstract

OBJECTIVE

To examine the association between changes in prepregnancy body mass index (BMI) between a woman's first two pregnancies and incidence of preeclampsia in the second pregnancy.

METHODS

We performed a population-based retrospective cohort analysis using data on women's first two singleton pregnancies (n=136,884) in Missouri (1989-1997). The study was restricted to women without preeclampsia in the first pregnancy. Prepregnancy BMI (kg/m(2)) was categorized as underweight (less than 18.5), normal (18.5-24.9), overweight (25-29.9), and obese (30 or greater). Analyses were adjusted for confounders through multivariable logistic regression.

RESULTS

The incidence rate of preeclampsia in the second pregnancy was 2.0%. In comparison with women who were of normal BMI in both pregnancies, the risk for preeclampsia increased when BMI changed between the first two pregnancies from underweight to obese (odds ratio [OR] 5.6, 95% confidence interval [CI] 1.7-18.2), normal to overweight (OR 2.0, 95% CI 1.7-2.3), normal to obese (OR 3.2, 95% CI 2.5-4.2), and overweight to obese (OR 3.7, 95% CI 3.1-4.3). Being obese or overweight in both pregnancies was associated with increased risk of preeclampsia in the second pregnancy. Women who increased their BMI from underweight to normal or overweight between pregnancies had risks of preeclampsia comparable with those with normal BMI in both pregnancies. African-American, but not white, women who had a reduction in BMI from obese or overweight to normal between pregnancies remained at increased risk for preeclampsia.

CONCLUSION

Increases in prepregnancy BMI from normal weight to overweight or obese between pregnancies are associated with increased risk of preeclampsia in the subsequent pregnancy.

LEVEL OF EVIDENCE

II.

Authors+Show Affiliations

Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Medicine & Dentistry of New Jersey-Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA. Darios.T.Getahun@kp.orgNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

18055727

Citation

Getahun, Darios, et al. "Primary Preeclampsia in the Second Pregnancy: Effects of Changes in Prepregnancy Body Mass Index Between Pregnancies." Obstetrics and Gynecology, vol. 110, no. 6, 2007, pp. 1319-25.
Getahun D, Ananth CV, Oyelese Y, et al. Primary preeclampsia in the second pregnancy: effects of changes in prepregnancy body mass index between pregnancies. Obstet Gynecol. 2007;110(6):1319-25.
Getahun, D., Ananth, C. V., Oyelese, Y., Chavez, M. R., Kirby, R. S., & Smulian, J. C. (2007). Primary preeclampsia in the second pregnancy: effects of changes in prepregnancy body mass index between pregnancies. Obstetrics and Gynecology, 110(6), pp. 1319-25.
Getahun D, et al. Primary Preeclampsia in the Second Pregnancy: Effects of Changes in Prepregnancy Body Mass Index Between Pregnancies. Obstet Gynecol. 2007;110(6):1319-25. PubMed PMID: 18055727.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Primary preeclampsia in the second pregnancy: effects of changes in prepregnancy body mass index between pregnancies. AU - Getahun,Darios, AU - Ananth,Cande V, AU - Oyelese,Yinka, AU - Chavez,Martin R, AU - Kirby,Russell S, AU - Smulian,John C, PY - 2007/12/7/pubmed PY - 2008/1/18/medline PY - 2007/12/7/entrez SP - 1319 EP - 25 JF - Obstetrics and gynecology JO - Obstet Gynecol VL - 110 IS - 6 N2 - OBJECTIVE: To examine the association between changes in prepregnancy body mass index (BMI) between a woman's first two pregnancies and incidence of preeclampsia in the second pregnancy. METHODS: We performed a population-based retrospective cohort analysis using data on women's first two singleton pregnancies (n=136,884) in Missouri (1989-1997). The study was restricted to women without preeclampsia in the first pregnancy. Prepregnancy BMI (kg/m(2)) was categorized as underweight (less than 18.5), normal (18.5-24.9), overweight (25-29.9), and obese (30 or greater). Analyses were adjusted for confounders through multivariable logistic regression. RESULTS: The incidence rate of preeclampsia in the second pregnancy was 2.0%. In comparison with women who were of normal BMI in both pregnancies, the risk for preeclampsia increased when BMI changed between the first two pregnancies from underweight to obese (odds ratio [OR] 5.6, 95% confidence interval [CI] 1.7-18.2), normal to overweight (OR 2.0, 95% CI 1.7-2.3), normal to obese (OR 3.2, 95% CI 2.5-4.2), and overweight to obese (OR 3.7, 95% CI 3.1-4.3). Being obese or overweight in both pregnancies was associated with increased risk of preeclampsia in the second pregnancy. Women who increased their BMI from underweight to normal or overweight between pregnancies had risks of preeclampsia comparable with those with normal BMI in both pregnancies. African-American, but not white, women who had a reduction in BMI from obese or overweight to normal between pregnancies remained at increased risk for preeclampsia. CONCLUSION: Increases in prepregnancy BMI from normal weight to overweight or obese between pregnancies are associated with increased risk of preeclampsia in the subsequent pregnancy. LEVEL OF EVIDENCE: II. SN - 0029-7844 UR - https://www.unboundmedicine.com/medline/citation/18055727/Primary_preeclampsia_in_the_second_pregnancy:_effects_of_changes_in_prepregnancy_body_mass_index_between_pregnancies_ L2 - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&PAGE=linkout&SEARCH=18055727.ui DB - PRIME DP - Unbound Medicine ER -