Preeclampsia is associated with increased maternal body weight in a northeastern Brazilian population
1 Health Sciences Post-Graduate Program, Natal, RN, Brazil
2 Institute of Tropical Medicine of Rio Grande do Norte, Natal, RN, Brazil
3 Department of Biochemistry, Biosciences Center, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Natal, RN, Brazil
4 Institute of Science and Technology of Tropical Diseases (INCT-DT), Natal, RN, Brazil
5 Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
6 Department of Internal Medicine, Health Science Center, UFRN, Natal, RN, Brazil
7 Department of Obstetrics and Gynecology, Health Science Center, UFRN, Natal, RN, Brazil
BMC Pregnancy and Childbirth 2013, 13:159 doi:10.1186/1471-2393-13-159Published: 8 August 2013
Preeclampsia is a disease with great variability in incidence across the world. The mortality is higher in lower income countries, where it is the leading cause of maternal mortality. This study aimed to determine the frequency of and risk factors for preeclampsia in a low income population from an urban area of Brazil.
A prospective case control study of 242 women of which 30 developed preeclampsia, 4 had gestational hypertension, 2 had superimposed hypertension, 11 had spontaneous abortion, 13 were lost to follow up and 192 had normal pregnancy. This latter group was considered the normotensive controls. The rate of preeclampsia and the risk of cardiovascular disease, after onset of preeclampsia, were determined.
Of the 218 women who completed the study, the frequency of hypertensive disorder of pregnancy was 16.5% (36 of 218) and of preeclampsia was 13.8% (30 of 218). Women with preeclampsia had a higher body mass index (BMI), mean of 25.3 ± 4.8 compared to 23.5 ± 3.7 for the normotensive controls, p = 0.02. The risk of preeclampsia increased with BMI [Odds ratio (OR) 1.12, 95% Confidence Interval (CI = 1.02;1.24, p-value = 0.023)]. Women with preeclampsia developed chronic hypertension more often than normotensive controls (p = 0.043) and their systolic and ambulatory blood pressure monitoring was elevated (p = 0.034). Women with preeclampsia had higher BMI even 5 years post-pregnancy (p = 0.008).
Women who are overweight or older have an increased risk of preeclampsia. Previous history of preeclampsia increases the risk of early onset of chronic hypertension. Therefore, effective preventive measures are needed, particularly women at lower social economic stratum who have less access to proper medical care and adequate nutrition.