Super-obesity and risk for early and late PE

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Re : Super-obesity and risk for early and late PE

Postby alexa5 » Wed Jun 02, 2010 11:45 am

Completely agree about what you said about the weight thing during pregnancy... many of those that develop pre-e gain more weight in pregnancy because of the swelling/water weight--not typically because they ate a lot. In my case I gained weight very regularly starting in my 2nd trimester, and it never stopped. I wasn't eating more than usual, and actually once I hit 3rd trimester I was probably eating a little less due to heartburn issues, but gained weight quickly. I think I put on 30 pounds, and I delivered at 33 weeks--changing my diet wouldn't have changed my weight gain.

My doctor, just prior to my PIH setting in, had noticed I was curving up a bit high on the weight gain and suggested watching that, but I guess we both found out later that I was right in that I was gaining due to my eventual pre-e.

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Super-obesity and risk for early and late PE

Postby caryn » Tue May 25, 2010 11:20 pm

...BMI and rate of weight gain are synergistic risk factors that amplify the burden of pre-eclampsia among super-obese women...

So the heavier you are going into pregnancy, the higher your risk, and the more weight you gain in pregnancy, the higher your risk.

It's not yet known for certain whether or not losing weight between pregnancies will lower your risk, but it is known that women who undergo bariatric surgery have a much lower rate of preeclampsia. Talk to your docs about what recommendations are appropriate for you.

(That second part about rate of gain always seems messy to me, though. I gained a lot of weight but it was *all* water -- I was actually 30 pounds below my pregnancy starting weight 6 weeks postpartum and I wasn't overweight going in -- and I'm not convinced that cutting back on my calories would have done anything to protect me. There are some early studies into lifestyle changes where they've recommended women eat diets designed to help them gain less weight during pregnancy, and while those women didn't gain as much weight while pregnant, their rate of preeclampsia didn't change. And since the problem in preeclampsia has to do with the initial implantation of the placenta, which is what the data increasingly confirm, diet *in pregnancy* wouldn't affect preeclampsia rate because it couldn't affect placentation. So I wonder if the research isn't just picking up on the fact that women with preeclampsia tend to gain more water weight. That would be useful -- it means women gaining at a high rate can be moved to closer observation to catch preeclampsia -- but not theraputic.)

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