Elevated non-esterified fatty acids in obese women with late-onset preeclampsia: a cross-sectional study

Pre-eclampsia is a pregnancy-specific multisystem disorder and a major cause of maternal and neonatal morbidity and mortality. Late-onset preeclampsia, occurring at or after 34 weeks of gestation, is estimated to account for approximately 70-80% of cases and is more strongly associated with maternal metabolic factors, although placental involvement is not absent and is generally less pronounced. Maternal obesity and altered lipid metabolism may be associated with this phenotype; however, the relationship between non-esterified fatty acids (NEFA) and obesity in late-onset preeclampsia remains unclear.

This cross-sectional study assessed differences and correlations in circulating NEFA levels between obese and normal-weight women with late-onset preeclampsia. Seventy-three women with singleton pregnancies were consecutively recruited, including 44 obese and 29 normal-weight participants classified using WHO Asia-Pacific BMI criteria. Clinical and biochemical data were obtained from medical records and maternal serum NEFA levels were measured using enzyme-linked immunosorbent assay (ELISA). Statistical analyses were performed using appropriate parametric or non-parametric tests, and correlations were assessed using Pearson or Spearman analysis.

A total of 73 women with late-onset preeclampsia were included (44 obese and 29 normal weight). Serum NEFA levels were significantly higher in obese women compared with normal-weight women (p = .008). BMI showed a weak but statistically significant positive correlation with NEFA levels (r = .23, 95% CI 0.007-0.442; p = .04), indicating a limited association between obesity and circulating NEFA levels within this study.

In women with late-onset preeclampsia, circulating NEFA levels were higher in the obese group and were weakly associated with BMI. These findings suggest an association between obesity and circulating NEFA levels within this clinical phenotype. However, due to the cross-sectional design and absence of normotensive control groups, causality and disease specificity cannot be determined. Further studies are needed to clarify the role of NEFA in preeclampsia.