Study identifies modifiable, treatable risk factors for pre-eclampsia

Obesity, diabetes mellitus, and chronic hypertension contribute to an increased risk of developing pre-eclampsia at a subsequent pregnancy, a study reports. Meanwhile, overweight, obesity, and a new diagnosis of interpregnancy hypertension are associated with recurrent pre-eclampsia.

The study examined the link between cardiometabolic risk factors and pre-eclampsia across two pregnancies in a high-risk cohort of 618 women who participated in the Boston Birth Cohort.

Of the 540 women without pre-eclampsia at the index pregnancy, 36 (7 percent) developed the disorder at their subsequent pregnancy. On the other hand, pre-eclampsia recurred in 33 out of the 78 women (42 percent) who had the disorder at the index pregnancy.

In log‐binomial regression models, women with vs without obesity were at higher risk of incident pre-eclampsia (unadjusted risk ratio [RR], 2.2, 95 percent confidence interval [CI], 1.1–4.5) and recurrent pre-eclampsia (unadjusted RR, 3.1, 95 percent CI, 1.5–6.7).

Pre-index pregnancy chronic hypertension and diabetes mellitus were associated with incident, but not recurrent, preeclampsia (unadjusted RRs, 7.9, 95 percent CI, 4.1–15.3 and unadjusted RR, 5.2, 95 percent CI, 2.5–11.1.

Finally, women with vs without new interpregnancy hypertension were at higher risk of incident (unadjusted RR, 6.1, 95 percent CI, 2.9–13) or recurrent pre-eclampsia (unadjusted RR, 2.4, 95 percent CI, 1.5–3.9).

In light of the findings, clinicians who care for women of childbearing age and manage chronic disease should are advised to take into account a history of pregnancy complications such as pre-eclampsia and consider programmes focused on prevention and management of cardiometabolic risk factors in the pre-pregnancy and interpregnancy periods.