title: Metabolic syndrome after pregnancies complicated by pre-eclampsia or small-for-gestational-age: a retrospective cohort.
abstract: OBJECTIVE
  To study the prevalence of metabolic syndrome in women after a pregnancy complicated by pre-eclampsia or small-for-gestational-age (SGA), both epitomes of placental syndrome.
  
  
  METHODS
  A retrospective cohort study.
  
  
  METHODS
  Single tertiary centre for maternal medicine in the Netherlands.
  
  
  METHODS
  Women with a history of pre-eclampsia in absence of SGA (n = 742) or pregnancy complicated by normotensive SGA (n = 147) between 1996 and 2010.
  
  
  METHODS
  Women were routinely screened for underlying cardiometabolic and cardiovascular risk factors at least 6 months postpartum. Logistic regression analysis was used to calculate the odds ratio and adjusted odds ratio for each group. Adjustments were made for age, maternal height, smoking, parity, and interval between delivery and measurement.
  
  
  METHODS
  Prevalence of the metabolic syndrome.
  
  
  RESULTS
  The prevalence of the metabolic syndrome in our population was two-fold higher for women with a history of pre-eclampsia (13.9%) compared with women with a history of SGA (7.6%). Calculated odds ratios for metabolic syndrome, fasting insulin, HOMA, and microalbuminuria were all higher for women with a history of pre-eclampsia compared with women with SGA. This difference persisted after adjustment for confounding factors: metabolic syndrome (adjusted odds ratio, aOR 2.11; 95% confidence interval, 95% CI 1.00-4.47) and hyperinsulinaemia (aOR 1.78; 95% CI 1.13-2.81) insulin resistance (HOMAIR ; aOR 1.80; 95% CI 1.14-2.86). Microalbuminuria (aOR 1.58; 95% CI 0.85-2.93) did not reach the level of significance after adjustment for confounding factors.
  
  
  CONCLUSIONS
  A history of pre-eclampsia, rather than SGA, was associated with metabolic syndrome, suggesting that it relates to maternal rather than fetal etiology of placental syndrome.
authors.affiliation: GROW, School for Oncology and Developmental Biology, Department of Obstetrics & Gynaecology, Maastricht University Medical Centre, Maastricht, the Netherlands.
authors.forename: S
authors.initials: S
authors.lastname: Al-Nasiry
authors.affiliation: GROW, School for Oncology and Developmental Biology, Department of Obstetrics & Gynaecology, Maastricht University Medical Centre, Maastricht, the Netherlands.
authors.forename: C
authors.initials: C
authors.lastname: Ghossein-Doha
authors.affiliation: GROW, School for Oncology and Developmental Biology, Department of Obstetrics & Gynaecology, Maastricht University Medical Centre, Maastricht, the Netherlands.
authors.forename: S E J
authors.initials: SE
authors.lastname: Polman
authors.affiliation: GROW, School for Oncology and Developmental Biology, Department of Obstetrics & Gynaecology, Maastricht University Medical Centre, Maastricht, the Netherlands.
authors.forename: S
authors.initials: S
authors.lastname: Lemmens
authors.affiliation: Department of Obstetrics and Gynaecology, Radboud University Medical Centre, Nijmegen, the Netherlands.
authors.forename: R R
authors.initials: RR
authors.lastname: Scholten
authors.affiliation: Department of Obstetrics and Gynaecology, Radboud University Medical Centre, Nijmegen, the Netherlands.
authors.forename: W M
authors.initials: WM
authors.lastname: Heidema
authors.affiliation: GROW, School for Oncology and Developmental Biology, Department of Obstetrics & Gynaecology, Maastricht University Medical Centre, Maastricht, the Netherlands.
authors.forename: J J
authors.initials: JJ
authors.lastname: Spaan
authors.affiliation: GROW, School for Oncology and Developmental Biology, Department of Obstetrics & Gynaecology, Maastricht University Medical Centre, Maastricht, the Netherlands.
authors.forename: M E A
authors.initials: ME
authors.lastname: Spaanderman
mesh_terms: D000293:Adolescent; D000328:Adult; D000419:Albuminuria / Q000453:epidemiology; D005260:Female; D006801:Humans; D006946:Hyperinsulinism / Q000453:epidemiology; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age; D007333:Insulin Resistance; D016015:Logistic Models; D024821:Metabolic Syndrome / Q000453:epidemiology*; D008875:Middle Aged; D009426:Netherlands; D011225:Pre-Eclampsia / Q000453:epidemiology*; D011247:Pregnancy; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D055815:Young Adult
keywords: Fetal growth restriction; insulin resistance; metabolic syndrome; placental syndrome; pre-eclampsia