Obesity increases risk of preeclampsia by 4x

[annegarrett]

The risk of preeclampsia rises with increases in body mass index before pregnancy

Rigorous analysis of data on 1,188 women pregnant with their first child with respect to body mass index (BMI) and risk of preeclampsia reveals a sharp increase in risk from a BMI of 16 to 35, according to Lisa M. Bodnar, Ph.D., MPH, R.D., a postdoctoral fellow at the Magee-Womens Research Institute.

Preeclampsia is a complication of pregnancy that is potentially life threatening to both mother and baby. It affects some 5 percent of first pregnancies. A measure of body fatness, BMI is derived by a formula using weight and height. A BMI of 25 or more is considered overweight for women. A BMI of 30 or higher is considered obese.

"The overall incidence of preeclampsia was 4.2 percent," said Dr. Bodnar. "After adjusting for other factors such as age and smoking, we found that preeclampsia risk increased along with BMI."

Compared with a BMI of 21, preeclampsia risk was two-fold for a woman with a BMI of 26, three-fold for a woman with a BMI of 30 and four-fold for a woman with a BMI of 34, she said.

"With the rate of obesity increasing in the United States, this is a worrisome development," Dr. Bodnar said. "However, our results suggest that it's possible even a small reduction in BMI could reduce preeclampsia risk."

Additional authors include Nina Markovic, Ph.D.; Gail Harger and James M. Roberts, M.D.


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CONTACT: Michele D. Baum
Clare Collins
PHONE: 412-647-3555
FAX: 412-624-3184
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collCX@upmc.edu




Anne Garrett
Executive Director
Preeclampsia Foundation

[jeffy37]

The sad thing is that at my last ob/gyn appt, I told her that I was considering becoming pregnant again, and asked if there was anything I could do beforehand to prevent preeclampsia the second time around. She said no, even though I had a BMI of around 32 at the time. She didn't even broach the subject of weight loss and exercise with me.

Luckily, I do as much reading as I can and had already decided to start a diet and exercise plan. I told her as much and she said it "couldn't hurt". Wow. I don't know if all doctors are reluctant to discuss weight loss, but I frankly wish mine had suggested it. It would have made me feel like I was doing the right thing and that she was on top of her game as far as knowing what to do to help me.

I'm doing great with my new routine--I've already lost 15 pounds! I'm aiming for about 35 more before I get to my goal (and start thinking about that second baby!)



Jenny (26)
dh Mike (27)
Evan 1/21/02 (31 weeks)
http://www.creamofpotatosoup.com

[laura]

Good for you, Jenny! I need to work on that as well.

Laura
Moderator/AK Coordinator

Mom to Alicia (severe PE) 5/98 and Camille (htn, oligo) 4/03
http://www.babiesonline.com/babies/c/camilleandallie/

[catherine]

Good for you Jenny, heaven knows it's hard to do. Here in AR where the debate re: public recognition and response/intervention is really hotting up.. some school districts are sending home kids BMI values with their report cards.

Just one other thing... there is data out there to say that tending towards the other end of the scale (BMIs that are low) is not a good thing in pregnancy either.. there is an increased incidence of preterm labor and early delivery. Can't exactly remember the data right now (generated in Sweden I believe) but I'll dig this up if anyone wants it.

Catherine
Mom to Finn, Lucy (preeclampsia and HELLP) and Chloe.
Moderator HELLP Syndrome Survivors

[catherine]

Ack!!! I just heard a report on this on the 2 pm(Central)news on NPR. Don't ask why the radio is on in my office.... The report was pretty bald, suggesting that BMI should be used by OBs to predict which women might be at increased risk for preeclampsia.

Jenny, I have a question for you. One of my co-workers has chronic hypertension, unmasked when she was pregnant with her one and only son. We were chatting about how well it was controlled with meds etc. She is fairly overweight, don't know exactly how much, but she was complaining about her knees etc. hurting her. She was quite forthright about saying that she was pretty sure her extra bulk wasn't helping with respect to joint pain etc. No pressure from her PP to think about dropping a few pounds. However, her PP is apparently pretty large, and my co-worker is beginning to think that her doctor isn't confronting personal weight issues and so is disinclined to encourage her (co-worker, sorry mangling pronouns...hope Carol doesn't catch me) to try and lose the extra weight... anticipating an improvement in BP etc also.

This rang bells with me from your previous post, and I wondered if you thought that such external factors might influence your OB. Size is such a tricky issue... I had a male OB last time around and I'm not certain that he'd have noticed if I'd gained 100 lbs unless it was within a week LOL! I've never gotten any feedback from either of my previous OBs (female) though.

Dare I ask the question... will reports like this, scientifically valid as it is but hardly the whole picture and neither a preventative or a cure, make people characterize preeclampsia as a disease of overweight women?

Catherine
Mom to Finn, Lucy (preeclampsia and HELLP) and Chloe.
Moderator HELLP Syndrome Survivors

[annegarrett]

Unfortunately, it already is happening and in meeting with our members--many of us do struggle with excess weight so it is clearly a piece (in my mind--she says cursing the extra 30#s she carries around) of the puzzle for some of us. BUT whether or not we are women who are inclined towards excess weight and that makes us have preeclampsia or whether we just have excess weight and it is a causal factor, or what makes us big also makes us get preeclampsia (you know chicken/egg 101 stuff) I don't know--but in talking with a lot of people over the course of years--I hear it again and again--that weight is a factor for many of our women. I think potentially it allows researchers an easy out. It is that whole diet argument. Just as diet impacts cardiovascular disease, diabetes, joint pain, etc...., so it appears to impact preeclampsia.

I don't think any of us would argue that healthy eating and a proper BMI would be ideal and as best we can--should be a goal if we have had preeclampsia and want to try again.

It is a tricky area for us--hopefully we can own what is ours like Jenny is doing--while not letting people say that this is why we get sick so therefore it is our own fault.

And before you write and tell me how you are thin and still got sick--trust me--I know--we have a lot of very fit, healthy even women get very sick--so clearly overweight is only one piece of the puzzle and for some women--not even a piece of their puzzle.

Take care,



Anne Garrett
Executive Director
Preeclampsia Foundation

[taras mom]

Interesting points, Catherine (and your pronouns are fine[;)]). Is it my imagination, or have doctors become less inclined to advise people to lose weight over the last few decades? Seems like that was what drove the jogging and aerobics crazes of the '70s and '80s. Now that I think about it, the only doctors and nurses who have ever advised me to lose weight were the thin ones. I've often heard women say that they prefer plump doctors for that reason.

Much as I hate to see women stigmatized for being overweight, it's even worse to think that symptoms might be ignored or downplayed in normal-range or thin women because "skinny women don't get preeclampsia."



Carol (38)
DH Bill (40)
Tara Mairichi
12/7-12/9, 2002
The Mightiest Little Angel

[catherine]

To be honest Carol, I hadn't thought of it quite that way. I was just thinking that this, along with diet (not calorie intake, but quality of nutrition) are areas where "control" issues arise. I'm a product of my genes, whatever they may be, not in my area of control. In terms of what I can manipulate, I'm not now nor have been for many years overweight and feel that I achieved a reasonably adequate level of nutrition when I was pregnant (x3). I do still feel some level of guilt that I may have in some way contributed to getting preeclampsia. Last time around I was constantly trying to draw comparisons between my two previous pregnancies, with little or no success. I think I'm going to name the syndrome Post Preeclampsia Paranoia (PPP). I didn't start on some campaign to have the best possible pregnancy (health/excercise/diet/weight) when I found out that I was pregnant with Chloe, I hadn't the energy frankly. So, I did feel a bit that if it came back again, I would be partially to blame. Intellectually, I totally agree with the nutritional data etc. but there's still sometimes a disconnect KWIM?

Laboriously getting around to my point, is advice like this a double-edged sword? On the one hand here is something specific that you can do that might reduce some of your risk of a reoccurance (after all, it was a first-timers study) and we have all endlessly bemoaned the loss of control we felt; on the other hand, yet another stick to beat yourself with?

Catherine
Mom to Finn, Lucy (preeclampsia and HELLP) and Chloe.
Moderator HELLP Syndrome Survivors

[taras mom]

Definitely a double-edged sword with a big "PPP" crest engraved in the pommel. At my age, I have to balance the desire to lose more weight before getting pregnant with the need to do so before menopause.[:(!] Will the value of losing another 10 pounds be offset by the age I gain while I'm doing so? There's no way to tell. Still, as you point out, it's something to do.

Carol (38)
DH Bill (40)
Tara Mairichi
12/7-12/9, 2002
The Mightiest Little Angel

[sjs40]

Im with you Carol.....at the age of 40 I have a lot of weight to lose but Im ever aware that time is moving on, and wonder whether I am better to be heavy and slightly younger or much lighter and older! It is definately something positive to do though.

Sue (40)
Chris (37)
DD Eleanor Susan (Ellie)
born at 27wks severe PE
24 July 03 - 20 August 03