title: Maternal obesity and the risk of placental vascular disease.
abstract: 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.
authors.affiliation: Department of Medicine, Division of Endocrinology and Metabolism, University of Toronto, Toronto ON.
authors.forename: Taryn
authors.initials: T
authors.lastname: Becker
authors.affiliation: Institute for Clinical Evaluative Sciences, Sunnybrook and Women's College Health Sciences Centre, University of Toronto, Toronto ON.
authors.forename: Marian J
authors.initials: MJ
authors.lastname: Vermeulen
authors.affiliation: Department of Genetics, York Central Hospital, Richmond Hill ON.
authors.forename: Philip R
authors.initials: PR
authors.lastname: Wyatt
authors.affiliation: St. Michael's Hospital, University of Toronto, Toronto ON.
authors.forename: Chris
authors.initials: C
authors.lastname: Meier
authors.affiliation: 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.
authors.forename: Joel G
authors.initials: JG
authors.lastname: Ray
mesh_terms: 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