title: Pre-Pregnancy BMI, Gestational Weight Gain, and the Risk of Hypertensive Disorders of Pregnancy: A Cohort Study in Wuhan, China.
abstract: BACKGROUND
  Hypertensive disorders of pregnancy (HDP) are major causes of maternal death worldwide and the risk factors are not fully understood. Few studies have investigated the risk factors for HDP among Chinese women. A cohort study involving 84,656 women was conducted to investigate pre-pregnancy BMI, total gestational weight gain (GWG), and GWG during early pregnancy as risk factors for HDP among Chinese women.
  
  
  METHODS
  The study was conducted between 2011-2013 in Wuhan, China, utilizing data from the Maternal and Children Healthcare Information Tracking System of Wuhan. A total of 84,656 women with a live singleton pregnancy were included. Multiple unconditional logistic regression was conducted to evaluate associations between putative risk factors and HDP.
  
  
  RESULTS
  Women who were overweight or obese before pregnancy had an elevated risk of developing HDP (overweight: OR = 2.66, 95% CI = 2.32-3.05; obese: OR = 5.53, 95% CI = 4.28-7.13) compared to their normal weight counterparts. Women with total GWG above the Institute of Medicine (IOM) recommendation had an adjusted OR of 1.72 (95% CI = 1.54-1.93) for HDP compared to women who had GWG within the IOM recommendation. Women with gestational BMI gain >10 kg/m2 during pregnancy had an adjusted OR of 3.35 (95% CI = 2.89-3.89) for HDP, compared to women with a gestational BMI gain <5 kg/m2. The increased risk of HDP was also observed among women with higher early pregnancy (up to 18 weeks of pregnancy) GWG (>600g/wk: adjusted OR = 1.48, 95% CI = 1.19-1.84).
  
  
  CONCLUSIONS
  The results from this study show that maternal pre-pregnancy BMI, early GWG, and total GWG are positively associated with the risk of HDP. Weight control efforts before and during pregnancy may help to reduce the risk of HDP.
authors: Wuhan Women and Children Health Care Center, Wuhan, Hubei, People's Republic of China.
authors: Aifen
authors: A
authors: Zhou
authors: Wuhan Women and Children Health Care Center, Wuhan, Hubei, People's Republic of China; Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of China.
authors: Chao
authors: C
authors: Xiong
authors: Wuhan Women and Children Health Care Center, Wuhan, Hubei, People's Republic of China.
authors: Ronghua
authors: R
authors: Hu
authors: Wuhan Women and Children Health Care Center, Wuhan, Hubei, People's Republic of China.
authors: Yiming
authors: Y
authors: Zhang
authors: Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT, United States of America.
authors: Bryan A
authors: BA
authors: Bassig
authors: Department of Epidemiology, Brown University School of Public Health, Providence, RI, United States of America.
authors: Elizabeth
authors: E
authors: Triche
authors: Wuhan Women and Children Health Care Center, Wuhan, Hubei, People's Republic of China.
authors: Shaoping
authors: S
authors: Yang
authors: Wuhan Women and Children Health Care Center, Wuhan, Hubei, People's Republic of China.
authors: Lin
authors: L
authors: Qiu
authors: Wuhan Women and Children Health Care Center, Wuhan, Hubei, People's Republic of China.
authors: Yaqi
authors: Y
authors: Zhang
authors: Wuhan Women and Children Health Care Center, Wuhan, Hubei, People's Republic of China.
authors: Cong
authors: C
authors: Yao
authors: Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of China.
authors: Shunqing
authors: S
authors: Xu
authors: Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of China.
authors: Youjie
authors: Y
authors: Wang
authors: Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of China.
authors: Wei
authors: W
authors: Xia
authors: Department of Epidemiology, College for Public Health and Social Justice, Saint Louis University, MO, United States of America.
authors: Zhengmin
authors: Z
authors: Qian
authors: Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT, United States of America.
authors: Tongzhang
authors: T
authors: Zheng
authors: Wuhan Women and Children Health Care Center, Wuhan, Hubei, People's Republic of China.
authors: Bin
authors: B
authors: Zhang
mesh_terms: D000328:Adult; D001794:Blood Pressure; D015992:Body Mass Index; D002681:China / Q000453:epidemiology; D015331:Cohort Studies; D005260:Female; D006801:Humans; D046110:Hypertension, Pregnancy-Induced / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology*; D008875:Middle Aged; D016017:Odds Ratio; D011225:Pre-Eclampsia / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D011247:Pregnancy; D062486:Public Health Surveillance; D012307:Risk Factors; D015430:Weight Gain; D055815:Young Adult