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| Associations of pre-pregnancy body mass index, gestational weight gain with blood pressure in pregnancy |
| 1.Graduate School of Peking Union Medical College, Beijing, 100730; 2. National Research Institute for Family Planning; 3. Beijing Friendship Hospital, Capital Medical University; 4. The First Affiliated Hospital of Shantou University Medical College, Shantou; 5. Beijing Hypertension League Institute |
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Abstract Objective: To evaluate the effects of pre-pregnancy body mass index (BMI), gestational weight gain during early and mid pregnancy stage on blood pressure of pregnant women. Methods: An ambispective cohort study with pregnant women who established birth records archives in obstetrics clinic of the first affiliated hospital of Shantou university medical college and Beijing friendship hospital of capital medical university between March 2014 and December 2015 were conducted. Women aged 20-49 years old, Han Chinese, and with no history of hypertension or diabetes were included in the final analysis. Data of information was retrospectively collected during the physical examination at 8-12 gestational weeks. Three times of follow-up were conducted at 24, 32 and 36 gestational weeks, respectively. Linear mixed models and logistic regression models were separately used to evaluate the influence of pre-pregnancy BMI, gestational weight gain in early and mid pregnant stage on blood pressure and hypertensive disorders of pregnancy (HDP) of pregnant women. Results: Compared to women with normal weight (BMI were 18.5-23.9), systolic blood pressure (SBP) decreased 3.93 (95% CI: 4.71-3.15) mmHg of women with underweight, but SBP increased 3.99 (95% CI: 2.93-5.05) of women with overweight, and SBP increased 7.18 (95% CI: 5.50-8.87) mmHg of obese women (P for trend <0.001). The corresponding value of diastolic blood pressure (DBP) of women with underweight, overweight, and obese was 2.59 (95% CI: 3.19-1.98) mmHg, 3.12 (95% CI: 2.30-3.94) and 5.60 (95% CI: 4.29-6.90) mmHg, respectively, (P for trend <0.001). The multivariable adjusted ORs for HDP were 0.23 (95% CI: 0.04-0.79), 5.49 (95% CI: 2.70-10.95) and 11.42 (95% CI: 5.12-24.98) for underweight, overweight and obese women, respectively. Compared to women with gestational weight gain in early pregnancy of 0.5-2.0 kg, SBP and DBP increased 1.88 (95% CI: 1.03-2.72) and 0.54 (95% CI: -0.12-1.20) mmHg for women with gestational weight gain in early pregnancy >2.0 kg, respectively. SBP and DBP increased 2.17 (95% CI: 1.12-3.23) and 1.18 (95% CI: 0.37-1.99) mmHg for women with gestational weight gain in mid pregnancy above the Institute of Medicine (IOM) recommendation, when compared to women with gestational weight gain in mid pregnancy within the IOM recommendation. Conclusion: The results indicate a linear, independent and positive association of pre-pregnancy BMI with both SBP and DBP in pregnancy. Excessive weight gain of pregnant women during early and mid pregnancy stage can increase SBP. Pre-pregnancy overweight and obese can significantly increase the risk of HDP.
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