title: Antenatal waist circumference and hypertension risk.
abstract: OBJECTIVE
  To assess whether waist circumference at the first antenatal visit predicts risk of developing hypertension later in pregnancy.
  
  
  METHODS
  Pregnant women with singleton pregnancies (n = 1142, median age 29 years, interquartile range 25-32 years, 387 primigravidas) were recruited at their first antenatal visits. Using standardized methods, midwives determined the weights, heights (for calculation of body mass index [BMI]), and waist circumferences of all women. Eighty-two women developed pregnancy-induced hypertension, and 21 developed preeclampsia (hypertension with proteinuria).
  
  
  RESULTS
  The median waist circumference between 6 and 16 weeks' gestation was 79 cm (interquartile range 72-84 cm), and there was no significant relationship between waist circumference and gestational age. Greater waist circumference was noted in subjects who subsequently developed pregnancy-induced hypertension (median 81 versus 77 cm, Mann-Whitney U test, P =.002) or preeclampsia (median 80 versus 77 cm, P =.02). The conventional, nonpregnant waist circumference action level of 80 cm gave a Mantel-Haenszel odds ratio (OR) for pregnancy-induced hypertension of 1.8 (95% confidence interval [CI] 1.1, 2.9) and for preeclampsia of 2.7 (95% CI 1.1, 6.8), compared with waists of less than 80 cm. Body mass index values were higher in women who developed pregnancy-induced hypertension (median 26 versus 24, P =.001) or preeclampsia (median 26 versus 24, P =.02). The conventional action limit for a BMI of 25 had an OR for pregnancy-induced hypertension of 2.0 (95% CI 1.2, 3.4) and for preeclampsia of 1.9 (95% CI 0.7, 4.8). Results were similar when the analysis was restricted to data from primigravidas.
  
  
  CONCLUSIONS
  We conclude that waist circumference up to 16 weeks' gestation can predict pregnancy-induced hypertension and preeclampsia. Therefore, waist circumference could form the basis for health promotion involving raising awareness of the importance of or urging weight reduction for women planning pregnancies.
authors.affiliation: Department of Pathological Biochemistry, Glasgow Royal Infirmary University NHS Trust, Glasgow, Scotland, United Kingdom. nsattar@clinmed.gla.ac.uk  
authors.forename: N
authors.initials: N
authors.lastname: Sattar
authors.forename: P
authors.initials: P
authors.lastname: Clark
authors.forename: A
authors.initials: A
authors.lastname: Holmes
authors.forename: M E
authors.initials: ME
authors.lastname: Lean
authors.forename: I
authors.initials: I
authors.lastname: Walker
authors.forename: I A
authors.initials: IA
authors.lastname: Greer
mesh_terms: D000328:Adult; D001824:Body Constitution; D015992:Body Mass Index; D005260:Female; D005865:Gestational Age; D006801:Humans; D006973:Hypertension / Q000209:etiology*; D016017:Odds Ratio; D011225:Pre-Eclampsia / Q000209:etiology*; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000209:etiology*; D012306:Risk