Early-onset preeclampsia and the prevalence of postpartum metabolic syndrome.
OBJECTIVE
To determine the prevalence of the metabolic syndrome postpartum in women with a history of pregnancy complicated by early-onset vascular disorders compared with women with late-onset disorders.


METHODS
In this retrospective cohort study 849 women with a history of pregnancy complicated by vascular disorders (preeclampsia; gestational hypertension; hemolysis, elevated liver enzymes, low platelets syndrome; eclampsia; placental abruption; fetal growth restriction; and stillbirth as a result of placental insufficiency) were divided into early-onset (delivery before 32 weeks of gestation, n=376) and late-onset (delivery at or beyond 32 weeks, n=473). By use of four internationally accepted criteria to diagnose metabolic syndrome, we compared its prevalence in both groups using odds ratios (ORs), adjusted for maternal age, smoking, alcohol and coffee consumption, birth weight centile, stillbirth, and interval between delivery and measurements.


RESULTS
The metabolic syndrome was present in 15-25% of women after early-onset vascular-complicated pregnancy and in 10-14% of women after late-onset disease, depending on the criteria set used; adjusted OR 2.51 (95% confidence interval [CI] 1.66-3.80) using World Health Organization criteria; adjusted OR 2.01 (95% CI 1.37-2.96) using International Diabetes Federation criteria; adjusted OR 2.16 (95% CI 1.31-3.55) using Third Adult Treatment Panel (ATPIII) criteria; and adjusted OR 2.02 (95% CI 1.28-3.17) using Third Adult Treatment Panel updated criteria.


CONCLUSIONS
The prevalence of the metabolic syndrome postpartum is twice as high in women with a history of early-onset (delivery before 32 weeks) compared to late-onset vascular-complicated pregnancy (delivery at or beyond 32 weeks).


METHODS
II.
Stekkinger
Eva
E
From the Department of Obstetrics and Gynecology, University Hospital Groningen, Radboud University Medical Center Nijmegen and University Hospital Maastricht, the Netherlands.
Zandstra
Mirjam
M
Peeters
Louis L H
LLH
Spaanderman
Marc E A
MEA
D000328:Adult; D000419:Albuminuria; D001786:Blood Glucose / Q000032:analysis; D001794:Blood Pressure; D015992:Body Mass Index; D015331:Cohort Studies; D036861:Delivery, Obstetric; D005215:Fasting; D005260:Female; D005865:Gestational Age; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007328:Insulin / Q000097:blood; D024821:Metabolic Syndrome / Q000453:epidemiology*; D016017:Odds Ratio; D011225:Pre-Eclampsia / Q000503:physiopathology*; D011247:Pregnancy; D011644:Puerperal Disorders / Q000453:epidemiology*; D012189:Retrospective Studies; D014280:Triglycerides / Q000097:blood
D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007328:Insulin; D014280:Triglycerides