title: Normal and high-normal blood pressures, but not body mass index, are risk factors for the subsequent occurrence of both preeclampsia and gestational hypertension: a retrospective cohort study.
abstract: Blood pressure (BP) levels and body mass index (BMI) are known as risk factors for preeclampsia and gestational hypertension. However, there have been few investigations regarding the effects of BP and BMI levels on preeclampsia and gestational hypertension in the same cohort. In the present study, we conducted a retrospective cohort study using multiple logistic regression analysis. The cohort included 1,518 patients without nephritis. The unadjusted odds ratios (ORs) of preeclampsia and gestational hypertension were increased in pregnant women with normal BP (120-129 mmHg systolic or 80-84 mmHg diastolic), high-normal BP and hypertension in the second trimester compared to those with optimal BP. The unadjusted ORs of preeclampsia and gestational hypertension were also increased in obese women in the pre-pregnancy period compared to women with normal range BMI. When adjustment was made for both the BP levels and pre-pregnancy BMI levels, the ORs (95% confidence intervals) of normal BP, high-normal BP, hypertension and obesity for the subsequent occurrence of preeclampsia were 5.1 (2.2-12), 8.3 (3.1-22), 16 (5.0-50) and 2.0 (0.67-5.9), and those for the subsequent occurrence of gestational hypertension were 7.0 (2.6-19), 7.4 (2.1-25), 22 (6.1-83) and 1.3 (0.33-4.8), respectively. For the subsequent occurrence of preeclampsia or gestational hypertension, normal BP, high-normal BP and hypertension in the second trimester may be independent risk factors. Obesity in the pre-pregnancy period, however, may not be an independent risk factor.
authors.affiliation: Department of Obstetrics and Gynecology, Jichi Medical University School of Medicine, Japan. okuchi@jichi.ac.jp
authors.forename: Akihide
authors.initials: A
authors.lastname: Ohkuchi
authors.forename: Ryuhiko
authors.initials: R
authors.lastname: Iwasaki
authors.forename: Hirotada
authors.initials: H
authors.lastname: Suzuki
authors.forename: Chikako
authors.initials: C
authors.lastname: Hirashima
authors.forename: Kayo
authors.initials: K
authors.lastname: Takahashi
authors.forename: Rie
authors.initials: R
authors.lastname: Usui
authors.forename: Shigeki
authors.initials: S
authors.lastname: Matsubara
authors.forename: Hisanori
authors.initials: H
authors.lastname: Minakami
authors.forename: Mitsuaki
authors.initials: M
authors.lastname: Suzuki
mesh_terms: D000328:Adult; D001794:Blood Pressure / Q000502:physiology*; D015992:Body Mass Index; D015331:Cohort Studies; D005260:Female; D006801:Humans; D046110:Hypertension, Pregnancy-Induced / Q000453:epidemiology* / Q000503:physiopathology; D016015:Logistic Models; D009765:Obesity / Q000503:physiopathology; D011225:Pre-Eclampsia / Q000453:epidemiology* / Q000503:physiopathology; D011247:Pregnancy; D012189:Retrospective Studies; D012307:Risk Factors