title: Adult Pre-pregnancy Weight Change and Risk of Developing Hypertensive Disorders in Pregnancy.
abstract: While the association of pre-pregnancy body mass index (BMI) and hypertensive disorders in pregnancy (HDP) is well documented, little is known about the relationship between pre-pregnancy weight change and HDP. We examined the impact of adult pre-pregnancy weight change on the development of HDP.
  
  
  
  We included 2914 women, surveyed about every three years since 1996, from the 1973-78 cohort of the Australian Longitudinal Study on Women's Health. Women without hypertension or HDP were followed-up between 2003 and 2012. Generalised estimating equations were used to assess the effect of baseline BMI (mean age 20 years) and pre-pregnancy weight change on the incidence of HDP.
  
  
  
  Over 9 years of follow up, 301 incident HDP cases (6.3%) were reported from 4813 pregnancies. Overweight and obese women at the baseline survey were 1.67 (95% CI 1.3, 2.2) and 2.15 (95% CI 1.4, 3.3) times more likely to develop HDP than normal weight women, respectively. Compared with stable weight women, women with small (>1.5-2.5%) or moderate/high (>2.5%) annual weight gain had elevated risk of HDP (RR 1.67 95% CI 1.3, 2.2; RR 2.31, 95% CI 1.8, 3.0, respectively). Women who reported annual weight loss (>1.5%) between baseline and the average age of 24 years were 46% (95% CI 0.4, 0.8) less likely to develop HDP.
  
  
  
  Pre-pregnancy weight gain is associated with an increased risk of HDP, whereas early adult weight loss is associated with lower risk of HDP.
authors.affiliation: Centre for Longitudinal and Life Course Research, School of Public Health, The University of Queensland, Brisbane, Queensland, Australia.
authors.forename: Akilew A
authors.identifier: 0000-0002-3022-5230
authors.initials: AA
authors.lastname: Adane
authors.affiliation: Centre for Longitudinal and Life Course Research, School of Public Health, The University of Queensland, Brisbane, Queensland, Australia.
authors.forename: Gita D
authors.initials: GD
authors.lastname: Mishra
authors.affiliation: Centre for Longitudinal and Life Course Research, School of Public Health, The University of Queensland, Brisbane, Queensland, Australia.
authors.forename: Leigh R
authors.initials: LR
authors.lastname: Tooth
mesh_terms: D000328:Adult; D001315:Australia / Q000453:epidemiology; D001794:Blood Pressure; D015992:Body Mass Index; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D046110:Hypertension, Pregnancy-Induced / Q000453:epidemiology* / Q000503:physiopathology; D015994:Incidence; D008137:Longitudinal Studies; D050177:Overweight / Q000453:epidemiology* / Q000503:physiopathology; D011247:Pregnancy; D037841:Pregnant People; D012307:Risk Factors; D015430:Weight Gain; D016387:Women's Health; D055815:Young Adult
keywords: Early adult; Hypertensive disorders in pregnancy; Incidence; Prospective cohort; Weight change