title: Maternal adiposity and blood pressure in pregnancy: varying relations by ethnicity and gestational diabetes.
abstract: OBJECTIVE
  Greater maternal adiposity is a potentially modifiable risk factor for elevated blood pressure during pregnancy; however, the association has been little studied in Asian populations, and no study has evaluated potential differences in the adiposity-blood pressure relation between ethnic groups or interaction with gestational diabetes.
  
  
  METHODS
  We performed a cross-sectional evaluation of a Singapore mother-offspring cohort comprising 799 pregnant Chinese, Malay and Indian women. Data on body weight, height, skinfold thickness and glycaemia (oral glucose tolerance test) were collected during the 2nd trimester; peripheral SBP and DBP were measured using an oscillometric device and central pressures by noninvasive radial applanation tonometry. The associations between adiposity measures BMI and sum of skinfold thickness and blood pressure outcomes were examined by linear regression with adjustment for potential confounders.
  
  
  RESULTS
  Higher maternal BMI was associated with elevated peripheral and central pressures: the increases in pressure (mmHg) for each kg/m(2) increase in BMI were 1.19 (95% confidence interval, 1.03-1.36) for peripheral SBP, 0.76 (0.63-0.89) for peripheral DBP, 1.02 (0.87-1.17) for central systolic pressure and 0.26 (0.16-0.37) for central pulse pressure. The associations were generally stronger in Chinese women (P-interaction = 0.03 for central pulse pressure) and individuals with gestational diabetes (P-interaction = 0.03 for DBP and P-interaction = 0.046 for central systolic pressure). Similar patterns of results were found when using skinfold thickness as the measure of adiposity.
  
  
  CONCLUSIONS
  Maternal adiposity is associated with higher peripheral and central blood pressures during pregnancy. Stronger associations in Chinese women and individuals with gestational diabetes warrant further investigation.
authors.affiliation: aSaw Swee Hock School of Public Health, National University of Singapore and National University Health System bKK Women's and Children's Hospital cYong Loo Lin School of Medicine, National University of Singapore and National University Health System dDepartment of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System eDepartment of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System fSingapore Institute for Clinical Sciences, Agency for Science and Technology Research (A'STAR) gMedicine Dean's Office, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore hMedical Research Council Lifecourse Epidemiology Unit, University of Southampton iNIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK jLiggins Institute, University of Auckland, Auckland, New Zealand *Seang-Mei Saw and An Pan contributed equally to the writing of this article.
authors.forename: Wai-Yee
authors.initials: WY
authors.lastname: Lim
authors.forename: Kenneth
authors.initials: K
authors.lastname: Kwek
authors.forename: Yap-Seng
authors.initials: YS
authors.lastname: Chong
authors.forename: Yung-Seng
authors.initials: YS
authors.lastname: Lee
authors.forename: Fabian
authors.initials: F
authors.lastname: Yap
authors.forename: Yiong-Huak
authors.initials: YH
authors.lastname: Chan
authors.forename: Keith M
authors.initials: KM
authors.lastname: Godfrey
authors.forename: Peter D
authors.initials: PD
authors.lastname: Gluckman
authors.forename: Seang-Mei
authors.initials: SM
authors.lastname: Saw
authors.forename: An
authors.initials: A
authors.lastname: Pan
mesh_terms: D050154:Adiposity / Q000502:physiology*; D000328:Adult; D044466:Asian People; D001794:Blood Pressure; D015992:Body Mass Index; D001835:Body Weight; D002681:China; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D016640:Diabetes, Gestational / Q000208:ethnology; D005260:Female; D005951:Glucose Tolerance Test; D006801:Humans; D007194:India; D008296:Malaysia; D009035:Mothers; D009765:Obesity / Q000503:physiopathology; D011247:Pregnancy; D011248:Pregnancy Complications; D011262:Pregnancy Trimester, Second; D012044:Regression Analysis; D012307:Risk Factors