title: Prepregnancy obesity and complement system activation in early pregnancy and the subsequent development of preeclampsia.
abstract: OBJECTIVE
  We hypothesized that women who are obese before they become pregnant and also have elevations of complement Bb and C3a in the top quartile in early pregnancy would have the highest risk of preeclampsia compared with a referent group of women who were not obese and had levels of complement less than the top quartile.
  
  
  METHODS
  This was a prospective study of 1013 women recruited at less than 20 weeks' gestation. An EDTA-plasma sample was obtained, and complement fragments were measured using enzyme-linked immunosorbent assays. The data were analyzed using univariable and multivariable logistic regression analysis.
  
  
  RESULTS
  Women who were obese with levels of Bb or C3a in the top quartile were 10.0 (95% confidence interval, 3.3-30) and 8.8 (95% confidence interval, 3-24) times, respectively, more likely to develop preeclampsia compared with the referent group.
  
  
  CONCLUSIONS
  We demonstrate a combined impact of obesity and elevated complement on the development of preeclampsia.
authors.affiliation: Department of Obstetrics and Gynecology, University of Colorado Denver School of Medicine, Aurora, CO, USA.
authors.forename: Anne M
authors.initials: AM
authors.lastname: Lynch
authors.forename: Robert H
authors.initials: RH
authors.lastname: Eckel
authors.forename: James R
authors.initials: JR
authors.lastname: Murphy
authors.forename: Ronald S
authors.initials: RS
authors.lastname: Gibbs
authors.forename: Nancy A
authors.initials: NA
authors.lastname: West
authors.forename: Patricia C
authors.initials: PC
authors.lastname: Giclas
authors.forename: Jane E
authors.initials: JE
authors.lastname: Salmon
authors.forename: V Michael
authors.initials: VM
authors.lastname: Holers
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D015992:Body Mass Index; D003167:Complement Activation; D015926:Complement C3a / Q000378:metabolism*; D011415:Complement Factor B / Q000378:metabolism*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D016015:Logistic Models; D015999:Multivariate Analysis; D009765:Obesity / Q000097:blood / Q000150:complications* / Q000276:immunology; D011225:Pre-Eclampsia / Q000097:blood / Q000209:etiology* / Q000276:immunology; D011247:Pregnancy; D011446:Prospective Studies
chemical_list: D015415:Biomarkers; D015926:Complement C3a; D011415:Complement Factor B