Association of pre-pregnancy body mass index and rate of weight gain during pregnancy with maternal indicators of cardiometabolic risk

Abstract

Background/objective Changes in metabolism and extensive hemodynamic adjustments occur during normal pregnancy. The presence of maternal obesity imposes an overload to these physiological adaptations that may result in increased risk for the development of cardiometabolic complications during and after pregnancy. The aim of this study is to describe total cholesterol (TC), triglycerides (TG), glucose, and arterial blood pressure (BP) trajectories and to analyze the association of these cardiometabolic risk indicators during pregnancy with pre-pregnancy body mass index (pBMI) and monthly gestational weight gain (MGWG). Subjects/methods A prospective cohort study of pregnant women was conducted in Mexico City. Monthly samples of blood were taken during clinical follow-up and biochemical and blood pressure were measured during each visit. Adjusted linear mixed-effect regression models were fit to describe the trajectories of these biomarkers during pregnancy and to analyze the association with pBMI and MGWG. Results Seven hundred and twenty women were included of which 16.6% had pre-gestational obesity, 33.2% had pre-gestational overweight, 45.8% had normal pBMI and 4.4% had pre-gestational underweight. Women with pre-gestational obesity had higher lipids concentrations in the beginning of pregnancy (TC: $$\hat \beta$$ β ̂ = 33.08, p = 0.010; TG: $$\hat \beta$$ β ̂ = 31.29, p = <0.001) but the concentrations increased less than in women with normal pBMI (TC: $$\hat \beta$$ β ̂ = −14.18, p = 0.001; TG: $$\hat \beta$$ β ̂ = −5.42, p < 0.001). By the end of pregnancy, women with pre-gestational obesity had lower concentrations of lipids than women with normal pBMI. By contrast, women with pre-gestational obesity had higher glucose concentrations and higher BP levels than women with normal pBMI over pregnancy. Conclusions pBMI is differentially associated with longitudinal trajectories of maternal biochemical markers of cardiometabolic risk. MGWG did not significantly affect the biochemical indicators or BP trajectories. Our results suggest that pBMI is more relevant to predicting adverse cardiometabolic markers trajectories during pregnancy than MGWG.

Revisiting weight gain during gestation: body mass index and weight gain are associated with increased maternal cholesterol levels and higher risk of maternal supraphysiological hypercholesterolemia

“…While all analyzed lipids increased from PG to T1, T2, and T3, the increase in TC and LDL at T3 is higher in the NW women compared to OW and OB women, in comparison to previous reports [23][24][25]48]. Despite this information, there are few studies that have estimated whether there is an association between TC and LDL levels with parameters related to nutritional status [25]. In order to determine a possible relationship in the studied population, correlations were performed, which showed a negative correlation between TC at T3 and BMI at T1 and T3.…”

“…In addition, figure 2 shows that after the classification by nutritional status, the mean values for lipids change in a different manner. While all analyzed lipids increased from PG to T1, T2, and T3, the increase in TC and LDL at T3 is higher in the NW women compared to OW and OB women, in comparison to previous reports [23][24][25]48]. Despite this information, there are few studies that have estimated whether there is an association between TC and LDL levels with parameters related to nutritional status [25].…”

Behavior reallocations within 24‐h movement profiles and change in cardiometabolic biomarkers during pregnancy

“…Pregnancy is a state of progressive insulin resistance and hyperlipidemia [1, 2]. Individuals with prepregnancy overweight or obesity have higher levels of glucose, insulin, and lipids at the beginning of pregnancy compared with those with a healthy weight [3]. This increases risk for gestational diabetes [4] and its associated cardiometabolic consequences, which can impact long‐term risk for type 2 diabetes [5] and cardiovascular disease [6].…”

Association between maternal cardiometabolic markers and fetal growth in non-complicated pregnancies: a secondary analysis of the PRINCESA cohort

“…Furthermore, limited information is available on this topic for women from diverse ethnic backgrounds. This issue holds particular relevance for Latino American populations, where the prevalence of obesity and other cardiometabolic risk indicators during pregnancy has reached alarming levels, emphasizing the urgent need for evidence to perform adjustments in public health programs and policies 11 , 12 .…”