Preeclampsia is associated with increased maternal body weight in a northeastern Brazilian population.
BACKGROUND
Preeclampsia is a disease with great variability in incidence across the world. The mortality is higher in lower income countries, where it is the leading cause of maternal mortality. This study aimed to determine the frequency of and risk factors for preeclampsia in a low income population from an urban area of Brazil.


METHODS
A prospective case control study of 242 women of which 30 developed preeclampsia, 4 had gestational hypertension, 2 had superimposed hypertension, 11 had spontaneous abortion, 13 were lost to follow up and 192 had normal pregnancy. This latter group was considered the normotensive controls. The rate of preeclampsia and the risk of cardiovascular disease, after onset of preeclampsia, were determined.


RESULTS
Of the 218 women who completed the study, the frequency of hypertensive disorder of pregnancy was 16.5% (36 of 218) and of preeclampsia was 13.8% (30 of 218). Women with preeclampsia had a higher body mass index (BMI), mean of 25.3 ± 4.8 compared to 23.5 ± 3.7 for the normotensive controls, p = 0.02. The risk of preeclampsia increased with BMI [Odds ratio (OR) 1.12, 95% Confidence Interval (CI = 1.02;1.24, p-value = 0.023)]. Women with preeclampsia developed chronic hypertension more often than normotensive controls (p = 0.043) and their systolic and ambulatory blood pressure monitoring was elevated (p = 0.034). Women with preeclampsia had higher BMI even 5 years post-pregnancy (p = 0.008).


CONCLUSIONS
Women who are overweight or older have an increased risk of preeclampsia. Previous history of preeclampsia increases the risk of early onset of chronic hypertension. Therefore, effective preventive measures are needed, particularly women at lower social economic stratum who have less access to proper medical care and adequate nutrition.
Health Sciences Post-Graduate Program, Natal, RN, Brazil. crysaraujo@uol.com.br.
Edailna Maria de Melo
EM
Dantas
Flávio Venicio Marinho
FV
Pereira
José Wilton
JW
Queiroz
Diogo Luis de Melo
DL
Dantas
Gloria Regina Gois
GR
Monteiro
Priya
P
Duggal
Maria de Fatima
Mde F
Azevedo
Selma Maria Bezerra
SM
Jeronimo
Ana Cristina Pinheiro Fernandes
AC
Araújo
D000293:Adolescent; D000328:Adult; D001794:Blood Pressure; D015992:Body Mass Index; D001835:Body Weight; D001938:Brazil / Q000453:epidemiology; D016022:Case-Control Studies; D003404:Creatinine / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D011225:Pre-Eclampsia / Q000097:blood / Q000453:epidemiology*; D011247:Pregnancy; D011446:Prospective Studies; D012307:Risk Factors; D012959:Socioeconomic Factors; D014505:Urban Population / Q000706:statistics & numerical data*; D055815:Young Adult
D003404:Creatinine