Impact of metabolic risks on preeclampsia among women with different
early-pregnancy blood pressures based on 2017 AHA Guidelines: A
retrospective study
Abstract
Objective A blood pressure (BP) of 120-140/80-90 mmHg at
<20 weeks’ gestation is associated with risks for
preeclampsia. We aimed to explore the effect of maternal metabolic risk
factors on the strength of the association between blood pressure
thresholds based on 2017 American Heart Association (AHA) guidelines and
preeclampsia. Design Retrospective cohort study.
Setting The reproductive center is based in Shanghai, China.
Population or Sample Data from 78,016 women enrolled
between 2014 and 2019 from the medical record system of the center were
used. Methods This retrospective cohort study included 78,016
participants. Preeclampsia prevalence was analyzed among women of four
BP categories, stratified by maternal BMI and TG. Main outcome
measures Incidence of preeclampsia Results Maternal BMI and TG
showed a dose-response superimposed impact on the relationships between
BPs and preeclampsia rates. Although heightened risks for preeclampsia
were found in women with normal BMI (18.5-<25 kg/m2) and TG
(<90th, 2.04 mM) women at a BP of 120-140 /80-90 mmHg, women
with obesity (BMI ≥ 25 kg/m2) and (or) high TG (≥ 90th) showed higher
rates of preeclampsia. The preeclampsia risk was the highest in women
with obesity and high TG at a BP of 130-140/80-90 mmHg and over 140/90
mmHg, which was 6-fold, and 13-fold greater than normotensive women with
normal BMI and TG respectively. Conclusion Obesity and (or)
high TG tended to strengthen the association between BP over 130/80 mmHg
and risk of preeclampsia.