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Interpregnancy Weight Change and Hypertension During Pregnancy: A Systematic Review and Meta-analysis
Jose Alberto Martínez-Hortelano1, Iván Cavero-Redondo, Celia Álvarez-Bueno
1Universidad de Castilla-La Mancha, Health and Social Research Center, Cuenca, Spain; Universidad Politécnica y Artística del Paraguay, Asunción, Paraguay; Virgen de la Luz Hospital, Cuenca, Spain; and Universidad Autónoma de Chile, Faculty of Health Sciences, Talca, Chile.
Objective:
To synthesize evidence regarding the association between interpregnancy weight change and hypertensive disorders of pregnancy.
Data Sources:
MEDLINE, EMBASE, Cochrane Library, Web of Science, and ClinicalTrials.gov databases were systematically searched from the databases' interception until April 2019. Search strategy included the terms: "interpregnancy," "intergestational," "hypertension" and "hypertensive disorders."
Methods Of Study Selection:
Studies that assessed the relationship between interpregnancy weight change and hypertensive disorders of pregnancy were included. Twelve studies and 415,605 women were included in this systematic review and meta-analysis. We used Mendeley reference manager during the review process. Odds ratios (ORs) for the most adjusted models reported by the included articles and the corresponding 95% CIs were calculated. The no weight change category defined by each study was used as the reference category.
Tabulation, Integration, And Results:
Overall, there was an increased risk of hypertensive disorders of pregnancy associated with interpregnancy weight gain (OR 1.37; 95% CI 1.21-1.53; I=62.1%; P<.001). Additionally, interpregnancy weight loss was associated with lower risk of developing hypertensive disorders of pregnancy (OR 0.87; 95% CI 0.75-0.99; I=54.9%; P=.01), Finally, meta-regression showed that interpregnancy weight gain was associated with a graded increase in the risk of hypertensive disorders of pregnancy.
Conclusion:
This systematic review and meta-analysis provides evidence that interpregnancy weight gain is associated with an increased risk of hypertensive disorders of pregnancy, gestational hypertension, and preeclampsia.
Systematic Review Registration:
PROSPERO, CRD42018103002.
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