Department of Biomedical, Metabolic and Neural Sciences, International Doctorate School in Clinical and Experimental Medicine, Obstetrics and Gynecology Unit, Mother-Infant Department, Policlinic Hospital, University of Modena and Reggio Emilia, Modena, Italy.
Eur Rev Med Pharmacol Sci. 2022 Jan;26(11):3967-3972. doi: 10.26355/eurrev_202201_28966.
Obesity is a risk factor for the development of gestational hypertension, with important consequences for both the mother and fetus. This prospective observational study aims to propose an early prediction model of hypertensive disorders in pregnancy among obese women, through the bioelectrical impedance analysis (BIA) at the first trimester, thus allowing early recognition of obese women that are at risk to develop gestational hypertension, in order to target preventive interventions.
Singleton obese women (BMI ≥ 30 kg/m2) between the 9th and 12th week of pregnancy were included in the study. The exclusion criteria were chronic diseases, like type 2 diabetes mellitus, hypertension, and other medical pre-existing conditions. Eligible women were followed up at 20, 28, and 36 weeks of gestation by measuring blood pressure, weight, and body composition with the use of the BIA. The diagnosis of gestational hypertension was made after the 20th week of gestation. Pregnancy and perinatal outcomes were then recorded.
Of the 479 women included in the study, 85 (17.7%) developed gestational hypertension; the remaining 394 (82.3%) resulted to be normotensive. A higher rate of nulliparous women was found in the hypertensive group (50.6% vs. 37.6%, p = 0.02), together with a higher rate of induction of labor (55.3% vs. 40.9%, p = 0.02) and of small for gestational age (SGA) newborns (12.9% vs. 6.9%, p = 0.03). Significant differences emerged in the body composition between the two groups already from the first trimester, indeed women developing gestational hypertension showed elevated values of Total body Mass, FM, FFM, TBW (p < 0.02), and of leg's FM, FFM (p < 0.006). At the multivariate logistics regression, the risk of developing gestational hypertension resulted higher in women with elevated total body water levels in the first trimester (OR 1.10 95% CI 1.04 -1.92).
The BIA is a rapid, easy, non-invasive, and inexpensive tool to evaluate the body composition of obese pregnant women. It represents a promising predictor of hypertensive disorders in pregnancy, which allows an early identification of the patients at risk of developing gestational hypertension, thus opening a window of opportunity for strictly monitoring and target preventive intervention.
肥胖是妊娠高血压发展的一个风险因素，对母亲和胎儿都有重要影响。本前瞻性观察研究旨在通过孕早期生物电阻抗分析（BIA）为肥胖孕妇提出一种妊娠高血压疾病的早期预测模型，从而能够早期识别有发展为妊娠高血压风险的肥胖孕妇，以便进行有针对性的预防干预。
本研究纳入了孕 9 至 12 周的肥胖（BMI≥30kg/m2）的单胎孕妇。排除标准为慢性疾病，如 2 型糖尿病、高血压和其他预先存在的医疗条件。符合条件的孕妇在 20、28 和 36 周时通过血压、体重和使用 BIA 测量身体成分进行随访。妊娠 20 周后诊断为妊娠高血压。然后记录妊娠和围产期结局。
在 479 名纳入研究的女性中，有 85 名（17.7%）患有妊娠高血压；其余 394 名（82.3%）为血压正常。高血压组的初产妇比例较高（50.6%比 37.6%，p=0.02），同时催产率较高（55.3%比 40.9%，p=0.02）和小于胎龄儿（SGA）新生儿比例较高（12.9%比 6.9%，p=0.03）。两组在孕早期的身体成分就有显著差异，确实患有妊娠高血压的女性的全身质量、FM、FFM、TBW 值升高（p<0.02），腿部的 FM、FFM 值也升高（p<0.006）。在多元逻辑回归中，孕早期全身水含量升高的女性发生妊娠高血压的风险更高（OR 1.10，95%CI 1.04-1.92）。
BIA 是一种快速、简单、无创、廉价的工具，可用于评估肥胖孕妇的身体成分。它是妊娠高血压疾病的一个很有前途的预测指标，可以早期识别有发展为妊娠高血压风险的患者，从而为严格监测和有针对性的预防干预提供机会。
