Losing weight lowers risk of hypertensive disorders of pregnancy

Lifestyle interventions or bariatric surgery leading to preconceptional weight loss effectively reduces the risk of hypertensive disorders of pregnancy (HDP), such as pregnancy-induced hypertension (PIH) and pre-eclampsia (PE), reports a recent meta-analysis.

Drawing from the online databases of Embase, Medline, PubMed, Google Scholar, the Cochrane Databases, and Web of Science, a total of 29 studies were deemed eligible for detailed quantitative analysis. Thirteen studies (n=292,503) looked at weight loss after lifestyle modifications, while 16 (n=3,357) focused on bariatric surgery.

Three studies looked at the impact of preconception weight loss by lifestyle intervention on HDP and found a significant 48-percent reduction in risk (odds ratio [OR], 0.52, 95 percent confidence interval [CI], 0.35–0.77).

A similarly significant but weaker effect was reported for PE (OR, 0.86, 95 percent CI, 0.78–0.96), whereas no impact was observed for PIH (OR, 0.93, 95 percent CI, 0.754–1.15). In all cases, heterogeneity of evidence was small.

Weight loss by bariatric surgery likewise yielded benefits, significantly reducing the risk of HDP by 67 percent (OR, 0.33, 95 percent CI, 0.15–0.74), PIH by 69 percent (OR, 0.31, 95 percent CI, 0.21–0.46), and PE by 65 percent (OR, 0.35, 95 percent CI, 0.16–0.79).

“To further improve knowledge on underlying pathophysiologic mechanisms involved in the associations between preconceptional weight, HDP, and long-term health of mother and child, prospective preconception cohort studies should be conducted,” the researchers said.

“These studies should include overweight and obese primiparous women, assigned on a preconceptional weight-losing intervention, and with long-term follow up. This knowledge will be an investment in health of current and future generations,” they added.