The Effects of Pre-Pregnancy Body Mass Index andGestational Weight Gain on the Risk of Preeclampsia ata Tertiary Referral Hospital, Northern Tanzania

Citation: 
Nelago Tukondjeni Amagulu( nellyoyinbo@gmail.com ) Kilimanjaro Christian Medical University Collegehttps://orcid.org/0000-0002-7301-3254 Bariki Mchome Kilimanjaro Christian Medical Centre Julius Pius Alloyce Kilimanjaro Christian Medical Centre Kingsly Tobi University of Namibia School of Medicine Eusebius Maro Kilimanjaro Christian Medical Centre
Publication year: 
2020

 ackground:

Pre/eclampsia and other hypertensive disorders of pregnancy contributed to 18% of the maternal mortality reported in Northern Tanzanian. There is increasing prevalence of obesity in Tanzania which is related to excessive weight gain in pregnancy. Both high BMI and excessive gestation weight gain are identied to increase risk of PE and subtypes, however this is still inconclusive and little is known about the joint effect of prepregnancyBMI and GWG on risk of PE and its subtypes in Africa. We evaluated the independent and joint effects of pre-pregnancy BMI and GWG on the risk of pre-eclampsia and its subtypes among women who delivered at Kilimanjaro Christian Medical Center (KCMC) from October 2018 to May 2019, Northern Tanzania.

Methods:

We performed a retrospective birth cohort study from October 2018 to May 2019 at KCMC, Tanzania. Pre-pregnancy BMI was categorized using WHO categories into Underweight ( 18.5kg/m²), Normal weight (18.524.9kg/m²),Overweight (25-29.9kg/m²) and Obese (≥ 30kg/m²). Gestational Weight Gain (GWG) was categorized using the 2009 Institute of Medicine (IOM) guidelines into Inadequate, Adequate and Excessive weight gain in pregnancy. Multinomial logistic regression analysis was used to adjust for confounders using relative risk, 95% condence interval for the risk ratios (RR) that did not cross 1 and p<0.05 were regarded statistically signicant.

Results:

Among the 1309 women analysed, 5.3% were Underweight, 51.1% Normal weight, 26.9% Overweight and 16.7% were Obese. About 43.5% had excessive GWG. Women with PE were 9.5%. Both obesity and excessive GWG independently increased risk of PE with adjusted RR=2.42, 95%CI: 1.48-3.96 and RR=1.77, 95%CI: 1.16-2.69 when compared to normal BMI and adequate GWG respectively. Jointly, Obesity and Excessive GWG had the highest risk of PE (ARR=4.95, 95%CI: 2.21-11.10). The increased risk was similar for Mild PE (MPE), Severe PE or eclampsia (SP/E) and Late Onset PE (LOPE). No association was found for Early Onset PE (EOPE).

 

Conclusion:

Pre-pregnancy Obesity and Excessive GWG independently and jointly increases risk for PE and the risk varies by PE subtype.

External link: 
http://scholar.google.com/scholar_url?url=https://www.researchsquare.com/article...