Maternal obesity and the risk of placental vascular disease.
BACKGROUND
While elevated maternal weight in early pregnancy is associated with a higher rate of preeclampsia, the risk of placental abruption and placental infarction is unknown.


METHODS
We evaluated the risk of placental abruption, placental infarction, and preeclampsia in association with maternal weight quintile at approximately 17 weeks' gestation in 386 323 women with a singleton pregnancy who underwent maternal serum screening in Ontario.


RESULTS
After adjusting for age, ethnicity, parity, diabetes mellitus, and tobacco use, the odds ratio (OR) for preeclampsia was 4.1 (95% confidence interval [CI] 3.8-4.4) comparing the highest and lowest weight quintiles. Conversely, there was a lower risk of placental abruption or placental infarction, despite further adjustment for preeclampsia, gestational hypertension and drug dependence (OR 0.81, 95% CI 0.75-0.87).


CONCLUSIONS
Higher maternal weight in early pregnancy is associated with a higher risk of preeclampsia and a lower risk of placental abruption or placental infarction, a seeming paradox that requires further elucidation.
Becker
Taryn
T
Department of Medicine, Division of Endocrinology and Metabolism, University of Toronto, Toronto ON.
Vermeulen
Marian J
MJ
Institute for Clinical Evaluative Sciences, Sunnybrook and Women's College Health Sciences Centre, University of Toronto, Toronto ON.
Wyatt
Philip R
PR
Department of Genetics, York Central Hospital, Richmond Hill ON.
Meier
Chris
C
St. Michael's Hospital, University of Toronto, Toronto ON.
Ray
Joel G
JG
Departments of Medicine, Obstetrics and Gynecology and Health Policy Management and Evaluation. Divisions of Endocrinology and Metabolism, and General Internal Medicine. St. Michael's Hospital, University of Toronto, Toronto ON.
D000037:Abruptio Placentae / Q000453:epidemiology*; D000328:Adult; D005260:Female; D006801:Humans; D007238:Infarction / Q000453:epidemiology*; D009765:Obesity / Q000453:epidemiology*; D009864:Ontario / Q000453:epidemiology; D010920:Placenta / Q000098:blood supply*; D011225:Pre-Eclampsia / Q000453:epidemiology*; D011247:Pregnancy; D012189:Retrospective Studies; D018570:Risk Assessment