title: Gestational Weight Gain, Body Mass Index, and Risk of Hypertensive Disorders of Pregnancy in a Predominantly Puerto Rican Population.
abstract: Objectives To prospectively evaluate the association between gestational weight gain (GWG), prepregnancy body mass index (BMI), and hypertensive disorders of pregnancy using the revised Institute of Medicine (IOM) Guidelines. Methods We examined these associations among 1359 participants in Proyecto Buena Salud, a prospective cohort study conducted from 2006 to 2011 among women from the Caribbean Islands. Information on prepregnancy BMI, GWG, and incident diagnoses of hypertension in pregnancy were based on medical record abstraction. Results Four percent (n = 54) of women were diagnosed with hypertension in pregnancy, including 2.6 % (n = 36) with preeclampsia. As compared to women who gained within IOM GWG guidelines (22.8 %), those who gained above guidelines (52.5 %) had an odds ratio of 3.82 for hypertensive disorders (95 % CI 1.46-10.00; ptrend = 0.003) and an odds ratio of 2.94 for preeclampsia (95 % CI 1.00-8.71, ptrend = 0.03) after adjusting for important risk factors. Each one standard deviation (0.45 lbs/week) increase in rate of GWG was associated with a 1.74 odds of total hypertensive disorders (95 % CI 1.34-2.27) and 1.86 odds of preeclampsia (95 % CI 1.37-2.52). Conclusions for Practice Findings from this prospective study suggest that excessive GWG is associated with hypertension in pregnancy and could be a potentially modifiable risk factor in this high-risk ethnic group.
authors.affiliation: Department of Biostatistics & Epidemiology, School of Public Health & Health Sciences, University of Massachusetts, 405 Arnold House, 715 North Pleasant Street, Amherst, MA, 01003-9304, USA. LCT@schoolph.umass.edu.
authors.forename: Lisa
authors.initials: L
authors.lastname: Chasan-Taber
authors.affiliation: Department of Biostatistics & Epidemiology, School of Public Health & Health Sciences, University of Massachusetts, 405 Arnold House, 715 North Pleasant Street, Amherst, MA, 01003-9304, USA.
authors.forename: Marushka
authors.initials: M
authors.lastname: Silveira
authors.affiliation: Division of Epidemiology of Chronic Diseases and Vulnerable Populations, Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, USA.
authors.forename: Molly E
authors.initials: ME
authors.lastname: Waring
authors.affiliation: Department of Biostatistics & Epidemiology, School of Public Health & Health Sciences, University of Massachusetts, 405 Arnold House, 715 North Pleasant Street, Amherst, MA, 01003-9304, USA.
authors.forename: Penelope
authors.initials: P
authors.lastname: Pekow
authors.affiliation: Department of Kinesiology, School of Public Health & Health Sciences, University of Massachusetts, Amherst, MA, USA.
authors.forename: Barry
authors.initials: B
authors.lastname: Braun
authors.affiliation: Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
authors.forename: JoAnn E
authors.initials: JE
authors.lastname: Manson
authors.affiliation: Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
authors.forename: Caren G
authors.initials: CG
authors.lastname: Solomon
authors.affiliation: Baystate Medical Center, Springfield, MA, USA.
authors.forename: Glenn
authors.initials: G
authors.lastname: Markenson
mesh_terms: D000293:Adolescent; D000328:Adult; D015992:Body Mass Index; D005260:Female; D006630:Hispanic or Latino / Q000706:statistics & numerical data*; D006801:Humans; D006973:Hypertension / Q000208:ethnology* / Q000209:etiology; D046110:Hypertension, Pregnancy-Induced / Q000208:ethnology*; D009765:Obesity / Q000150:complications*; D011225:Pre-Eclampsia / Q000453:epidemiology; D011247:Pregnancy; D011446:Prospective Studies; D011647:Puerto Rico / Q000453:epidemiology; D012307:Risk Factors; D015430:Weight Gain
keywords: Body mass index; Gestational hypertension; Gestational weight gain; Latina; Preeclampsia