TY - JOUR

T1 - Associations of childhood BMI and change in BMI from childhood to adulthood with risks of hypertensive disorders in pregnancy

AU - Pedersen, Dorthe C.

AU - Bjerregaard, Lise G.

AU - Nohr, Ellen A.

AU - Rasmussen, Kathleen M.

AU - Baker, Jennifer L.

PY - 2020

Y1 - 2020

N2 - Background: Maternal overweight (including obesity) is an established risk factor for gestational hypertension and pre-eclampsia. However, it is largely unknown whether body size before adulthood relates to these diseases.Objectives: We examined whether childhood BMI (in kg/m(2)) and changes in BMI from childhood to adulthood were associated with gestational hypertension and pre-eclampsia.Methods: Using the Copenhagen School Health Records Register. we studied 49,600 women born between 1940 and 1996 with height and weight measurements at 7 y and/or 13 y who had their first singleton birth between ages 18 and 45 y. Women with gestational hypertension (n = 496) and pre-eclampsia (n = 1804) were identified from the International Classification of Disease codes in the Danish National Patient Register. Adult overweight (including obesity) was defined as a BMI >= 25. We used log-linear binomial regression to estimate risk ratios (RRs) and 95% CIs.Results: At 13 y, as BMI increased above average (z score >0, or the 42nd percentile of the CDC BMI reference). RR for gestational hypertension was 1.66 (95% CI: 1.42, 1.94) and that for preeclampsia was 1.57 (95% CI: 1.46, 1.70) per BM I z score. In a subset of 13.160 women, development of overweight from childhood to adulthood and having overweight at both ages were associated with higher risks of the outcomes than in those with a normal BMI at both ages. No increased risks were observed in women whose BMI normalized from childhood to adulthood: RR was 2.04 (95% CI: 0.93, 4.47) for gestational hypertension and 1.11(95% CI: 0.63, 1.93) for pre-eclampsia.Conclusions: Above-average childhood BMI values and development of overweight from childhood to adulthood were associated with increased risks of gestational hypertension and pre-eclampsia, whereas normalizing BMI from childhood to conception attenuated the risks. Thus, interventions aiming at normalizing BMI in girls with high values may be warranted to help prevent these obstetric diseases.

AB - Background: Maternal overweight (including obesity) is an established risk factor for gestational hypertension and pre-eclampsia. However, it is largely unknown whether body size before adulthood relates to these diseases.Objectives: We examined whether childhood BMI (in kg/m(2)) and changes in BMI from childhood to adulthood were associated with gestational hypertension and pre-eclampsia.Methods: Using the Copenhagen School Health Records Register. we studied 49,600 women born between 1940 and 1996 with height and weight measurements at 7 y and/or 13 y who had their first singleton birth between ages 18 and 45 y. Women with gestational hypertension (n = 496) and pre-eclampsia (n = 1804) were identified from the International Classification of Disease codes in the Danish National Patient Register. Adult overweight (including obesity) was defined as a BMI >= 25. We used log-linear binomial regression to estimate risk ratios (RRs) and 95% CIs.Results: At 13 y, as BMI increased above average (z score >0, or the 42nd percentile of the CDC BMI reference). RR for gestational hypertension was 1.66 (95% CI: 1.42, 1.94) and that for preeclampsia was 1.57 (95% CI: 1.46, 1.70) per BM I z score. In a subset of 13.160 women, development of overweight from childhood to adulthood and having overweight at both ages were associated with higher risks of the outcomes than in those with a normal BMI at both ages. No increased risks were observed in women whose BMI normalized from childhood to adulthood: RR was 2.04 (95% CI: 0.93, 4.47) for gestational hypertension and 1.11(95% CI: 0.63, 1.93) for pre-eclampsia.Conclusions: Above-average childhood BMI values and development of overweight from childhood to adulthood were associated with increased risks of gestational hypertension and pre-eclampsia, whereas normalizing BMI from childhood to conception attenuated the risks. Thus, interventions aiming at normalizing BMI in girls with high values may be warranted to help prevent these obstetric diseases.

KW - adult

KW - BMI

KW - child

KW - cohort study

KW - gestational hypertension

KW - obesity

KW - overweight

KW - pre-eclampsia

KW - pregnancy

KW - BODY-MASS INDEX

KW - WEIGHT CHANGE

KW - PREECLAMPSIA

KW - HEALTH

KW - OVERWEIGHT

KW - OBESITY

KW - DISEASE

U2 - 10.1093/ajcn/nqaa187

DO - 10.1093/ajcn/nqaa187

M3 - Journal article

C2 - 32672337

VL - 112

SP - 1180

EP - 1187

JO - American Journal of Clinical Nutrition

JF - American Journal of Clinical Nutrition

SN - 0002-9165

IS - 5

ER -