Increased BMI has a linear association with late-onset preeclampsia: A population-based study

Area of Science:

• Obstetrics and Gynecology
• Perinatal Epidemiology
• Maternal Health

Background:

• Preeclampsia presents as early-onset (EOP) or late-onset (LOP), with ongoing debate regarding the influence of Body Mass Index (BMI).
• Investigating the distinct roles of maternal pre-pregnancy BMI and diabetes in EOP versus LOP is crucial for understanding disease heterogeneity.

Purpose of the Study:

• To clarify the independent effects of maternal pre-pregnancy BMI and diabetes on early-onset preeclampsia (EOP) and late-onset preeclampsia (LOP).
• To differentiate risk factors associated with EOP compared to LOP.

Main Methods:

• An 18-year observational cohort study (2001-2018) of approximately 4,300 births annually.
• Utilized a perinatal database collecting standardized information on pregnancy history, delivery, and neonatal outcomes.
• Employed multivariate analysis to assess independent risk factors for EOP and LOP.

Main Results:

• Chronic hypertension and prior preeclampsia in multigravidas were key risk factors for EOP.
• Primiparity, advanced maternal age (>35 years), and high BMI (≥35 kg/m²) were associated with LOP.
• Maternal age and pre-pregnancy BMI were independent risk factors for both EOP and LOP, with BMI increments specifically linked to LOP. Diabetes was not an independent risk factor for either EOP or LOP.

Conclusions:

• Metabolic factors related to maternal pre-pregnancy weight, beyond diabetes, are specifically associated with LOP.
• Findings may explain global disparities in LOP prevalence between high-income and medium-low income countries.
• Further research into metabolic factors influencing maternal corpulence is warranted for understanding preeclampsia.