Blood Pressure Changes during Pregnancy: Impact of Race, Body Mass Index, and Weight Gain

Magriples, Urania; Boynton, Marcella H.; Kershaw, Trace; Duffany, Kathleen O’Connor; Rising, Sharon Schindler; Ickovics, Jeannette R.

doi:10.1055/s-0032-1326987

Cited by 15 publications

(14 citation statements)

References 22 publications

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“…[2, 5–7] Moreover, in our study and in a similar cohort these differences remained stable over time. [2] Two other studies reported that these differences decreased slightly over time, as normal weight women had a more rapid increase in BP at the end of pregnancy compared to overweight and obese women.…”

Section: Discussionsupporting

confidence: 68%

Pre-pregnancy weight status, early pregnancy lipid profile and blood pressure course during pregnancy: The ABCD study

et al. 2017

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ObjectiveAlthough pre-pregnancy weight status and early pregnancy lipid profile are known to influence blood pressure course during pregnancy, little is known about how these two factors interact. The association between pre-pregnancy weight status and blood pressure course during pregnancy was assessed in the prospective ABCD study and the role (independent/mediating/moderating) of early pregnancy lipid profile in this association was determined.MethodsWe included 2500 normal weight (<25 kg/m2) and 600 overweight (≥25 kg/m2) women from the prospective ABCD-study with available measurements of non-fasting early pregnancy lipids [median (IQR): 13 (12–14) weeks of gestation] and blood pressure during pregnancy [mean (SD) = 10 (2.3)]. Lipids (triglycerides, total cholesterol, apolipoprotein A1, apolipoprotein B and free fatty acids) were divided into tertiles. Multilevel piecewise linear spline models were used to describe the course of systolic and diastolic blood pressure (SBP/DBP) in four time periods during gestation for overweight and normal weight women.ResultsBoth SBP (5.3 mmHg) and DBP (3.9 mmHg) were higher in overweight compared to normal weight women and this difference remained the same over all four time periods. The difference in SBP and DBP was not mediated or moderated by the lipid profile. Lipid profile had an independent positive effect on both SBP (range 1.3–2.2 mmHg) and DBP (0.8–1.1 mmHg), but did not change blood pressure course.ConclusionsBoth pre-pregnancy weight status and early pregnancy lipid profile independently increase blood pressure during pregnancy. Improving pre-pregnancy weight status and early pregnancy lipid profile might result in a healthier blood pressure course during pregnancy.

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Section: Discussionsupporting

confidence: 68%

Pre-pregnancy weight status, early pregnancy lipid profile and blood pressure course during pregnancy: The ABCD study

et al. 2017

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“…In our study, we had the ability to adjust for several important confounders, such as maternal age, smoking, early pregnancy BMI, and diabetes mellitus. 39,40 However, we did not have data on weight gain during pregnancy, which can affect blood pressure trajectories during pregnancy 39 and also the association with SGA. 41 Nor we had data on maternal ethnicity, which can affect both blood pressure trajectories during pregnancy and our outcomes.…”

Section: Strengths and Limitationsmentioning

confidence: 96%

“…41 Nor we had data on maternal ethnicity, which can affect both blood pressure trajectories during pregnancy and our outcomes. 39,42,43 Blood pressure measurements were collected during routine antenatal appointments by midwifes, and the measurements can, therefore, have inherent and interobserver variability. This would, however, only expect to introduce random rather than systemic error.…”

Section: Strengths and Limitationsmentioning

confidence: 99%

Prehypertension in Pregnancy and Risks of Small for Gestational Age Infant and Stillbirth

et al. 2016

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Abstract-It is not fully known whether maternal prehypertension is associated with increased risk of adverse fetal outcomes, and it is debated whether increases in blood pressure during pregnancy influence adverse fetal outcomes. We performed a population-based cohort study in nonhypertensive women with term (≥37 weeks) singleton births (n=157 446). Using normotensive (diastolic blood pressure [DBP] <80 mm Hg) women as reference, we calculated adjusted odds ratios with 95% confidence intervals between prehypertension (DBP 80-89 mm Hg) at 36 gestational weeks (late pregnancy) and risks of a small-for-gestational-age (SGA) birth or stillbirth. We further estimated whether an increase in DBP from early to late pregnancy affected these risks. We found that 11% of the study population had prehypertension in late pregnancy. Prehypertension was associated with increased risks of both SGA birth and stillbirth; adjusted odds ratios (95% confidence intervals) were 1.69 (1.51-1.90) and 1.70 (1.16-2.49), respectively. Risks of SGA birth in term pregnancy increased by 2.0% (95% confidence intervals 1.5-2.8) per each mm Hg rise in DBP from early to late pregnancy, whereas risk of stillbirth was not affected by rise in DBP during pregnancy. We conclude that prehypertension in late pregnancy is associated with increased risks of SGA birth and stillbirth. Risk of SGA birth was also affected by rise in DBT during pregnancy. Our findings provide new insight to the relationship between maternal blood pressure and fetal well-being and suggest that impaired maternal perfusion of the placenta contribute to SGA birth and stillbirth. (Hypertension.

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“…Women with a high body mass index (BMI) are more likely to have pregnancy complications and adverse maternal and perinatal outcomes including gestational diabetes (Hedderson et al, 2012; Solomon et al, 1997), pre-eclampsia (Baeten et al, 2001; Bodnar et al, 2005), high blood pressure (Magriples et al, 2013), placental dysfunction (Hastie and Lappas, 2014; Higgins et al, 2013), preterm births (Cnattingius et al, 2013; Wang et al, 2011), and infants born either large or small for gestational age (Djelantik et al, 2012). The prevalence of neurodevelopmental disorders have increased dramatically in parallel with the rise in obesity rates (Boyle et al, 2011; Elsabbagh et al, 2012; Fombonne, 2011), leading researchers to examine the impact of maternal obesity, weight gain during pregnancy, and prenatal diet on offspring behavior.…”

Section: Introductionmentioning

confidence: 99%

Maternal high-fat diet programming of the neuroendocrine system and behavior

Sullivan

Riper

Lockard

et al. 2015

Hormones and Behavior

145

108

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Maternal obesity, metabolic state, and diet during gestation have profound effects on offspring development. The prevalence of neurodevelopmental and mental health disorders has risen rapidly in the last several decades in parallel with the rise in obesity rates. Evidence from epidemiological studies indicates that maternal obesity and metabolic complications increase the risk of offspring developing behavioral disorders such as attention deficit hyperactivity disorder (ADHD), autism spectrum disorders (ASD), and schizophrenia. Animal models show that a maternal diet high in fat similarly disrupts behavioral programming of offspring, with animals showing social impairments, increased anxiety and depressive behaviors, reduced cognitive development, and hyperactivity. Maternal obesity, metabolic conditions, and high fat diet consumption increase maternal leptin, insulin, glucose, triglycerides, and inflammatory cytokines. This leads to increased risk of placental dysfunction, and altered fetal neuroendocrine development. Changes in brain development that likely contribute to the increased risk of behavioral and mental health disorders include increased inflammation in the brain, as well as alterations in the serotonergic system, dopaminergic system and hypothalamic pituitary adrenal (HPA) axis.

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Blood Pressure Changes during Pregnancy: Impact of Race, Body Mass Index, and Weight Gain

Cited by 15 publications

References 22 publications

Pre-pregnancy weight status, early pregnancy lipid profile and blood pressure course during pregnancy: The ABCD study

Pre-pregnancy weight status, early pregnancy lipid profile and blood pressure course during pregnancy: The ABCD study

Prehypertension in Pregnancy and Risks of Small for Gestational Age Infant and Stillbirth

Maternal high-fat diet programming of the neuroendocrine system and behavior

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