Risk factors for pre-eclampsia among Zimbabwean women: maternal arm circumference and other anthropometric measures of obesity.
Maternal pre-pregnancy obesity is a risk factor for pre-eclampsia (proteinuric hypertension in pregnancy) among North American and European women. We studied the relationship between maternal obesity and risk of pre-eclampsia among Zimbabwean women. A case-control study was conducted at Harare Maternity Hospital, Harare, Zimbabwe, between June 1995 and April 1996. Study participants were 144 women with pre-eclampsia and 194 normotensive women serving as controls. Maternal weight, height and mid-arm circumference were measured and recorded during study participants' postpartum hospital admission. Maternal mid-arm circumference, considered to be relatively stable during pregnancy among women of developing countries, was used as the primary indicator of maternal pre-pregnancy obesity. Logistic regression procedures were used to estimate odds ratios and 95% confidence intervals. There were linear trends in risk of pre-eclampsia with increasing mid-arm circumference, increasing weight and increasing body mass index. After adjusting for potential confounding factors, women in the highest quintile for mid-arm circumference (28-39 cm) were 4.4 times more likely to have had their pregnancy complicated by pre-eclampsia than women in the lowest quintile (21-23 cm). Odds ratios of similar magnitude were observed for the other anthropometric measures. To our knowledge, this is the first study to demonstrate a positive association between maternal obesity and pre-eclampsia risk in a black African population. Biological mechanisms thought to explain this relatively consistent epidemiological finding include endothelial cell injury, possibly resulting from hyperlipidaemia.
Mahomed
K
K
Department of Obstetrics and Gynaecology, University of Zimbabwe, School of Medicine, Harare, Zimbabwe.
Williams
M A
MA
Woelk
G B
GB
Jenkins-Woelk
L
L
Mudzamiri
S
S
Longstaff
L
L
Sorensen
T K
TK
D000328:Adult; D000886:Anthropometry; D001132:Arm / Q000033:anatomy & histology*; D001827:Body Height; D015992:Body Mass Index; D001835:Body Weight; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D009765:Obesity / Q000150:complications* / Q000473:pathology; D011225:Pre-Eclampsia / Q000209:etiology* / Q000473:pathology; D011247:Pregnancy; D012307:Risk Factors; D015030:Zimbabwe