Prepregnancy body mass index, hypertensive disorders of pregnancy, and long-term maternal mortality

Margaret E. Samuels-Kalow; Edmund F. Funai; Catalin Buhimschi; Errol Norwitz; Mary Perrin; Ronit Calderon-Margalit; Lisa Deutsch; Ora Paltiel; Yechiel Friedlander; Orly Manor; Susan Harlap

doi:10.1016/j.ajog.2007.04.043

Prepregnancy body mass index, hypertensive disorders of pregnancy, and long-term maternal mortality

Margaret E. Samuels-Kalow, Edmund F. Funai^*, Catalin Buhimschi, Errol Norwitz, Mary Perrin, Ronit Calderon-Margalit, Lisa Deutsch, Ora Paltiel, Yechiel Friedlander, Orly Manor, Susan Harlap

^*Corresponding author for this work

Braun School of Public Health and Community Medicine

Research output: Contribution to journal › Article › peer-review

54 Scopus citations

Abstract

Objective: Recent studies have shown increased maternal mortality rates after hypertensive disorders of pregnancy (HDP), but the reasons for this increase remain unclear. This study examines the relationship between elevated prepregnancy body mass index (BMI), HDP, and postpregnancy mortality. Study Design: Data came from a 1975-1976 subset (n = 13,722 women) of a population-based cohort. Multiple logistic regression was used to examine the risk of HDP by BMI; age-adjusted Cox proportional hazards models were used to examine survival rates. Results: Overweight (BMI, 25-29.9 kg/m²) and obesity (BMI, ≥30 kg/m²) were associated with increased HDP (odds ratio [OR], 2.82; 95% confidence interval [CI], 2.40-3.31 and OR, 5.51; 95% CI, 4.15-7.31]) and decreased survival (hazard ratio [HR], 1.42; 95% CI, 1.10-1.83 and HR, 2.43; 95% CI, 1.61-3.68), compared with normal weight (BMI, 18.5-24.9 kg/m²). HDP was significantly associated with increased mortality rates for women who survived >15 years (HR, 1.94; 95% CI, 1.42-2.67]; HR adjusted for BMI, 1.65; 95% CI, 1.19-2.79]). A greater increase in risk of death after HDP was seen in the overweight women (HR, 1.86; 95% CI, 1.07-3.20) and obese women (HR, 2.90; 95% CI, 1.28-6.58), compared with normal weight women (HR, 1.26; 95% CI, 0.74-2.14). Conclusion: Elevated prepregnancy BMI is associated with increased risk of HDP, which are in turn is associated with increased long-term maternal mortality rates. This association between HDP and mortality rates increases with elevated prepregnancy BMI.

Original language	English
Pages (from-to)	490.e1-490.e6
Journal	American Journal of Obstetrics and Gynecology
Volume	197
Issue number	5
DOIs	https://doi.org/10.1016/j.ajog.2007.04.043
State	Published - Nov 2007

Bibliographical note

Funding Information:
Supported by a summer research grant from National Institutes of Health–National Heart, Lung and Blood Institute through the Office of Student Research, Yale University School of Medicine (M.E.S-K.); by the National Center for Research Resources, RR15536-05 (E.F.F.); and by National Alliance for Research on Schizophrenia and Depression and the National Cancer Institute (2R01CA-080197; S.H.).

Keywords

body mass index
hypertensive disorders of pregnancy
maternal mortality

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1016/j.ajog.2007.04.043

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Samuels-Kalow, M. E., Funai, E. F., Buhimschi, C., Norwitz, E., Perrin, M., Calderon-Margalit, R., Deutsch, L., Paltiel, O., Friedlander, Y., Manor, O., & Harlap, S. (2007). Prepregnancy body mass index, hypertensive disorders of pregnancy, and long-term maternal mortality. American Journal of Obstetrics and Gynecology, 197(5), 490.e1-490.e6. https://doi.org/10.1016/j.ajog.2007.04.043

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title = "Prepregnancy body mass index, hypertensive disorders of pregnancy, and long-term maternal mortality",

abstract = "Objective: Recent studies have shown increased maternal mortality rates after hypertensive disorders of pregnancy (HDP), but the reasons for this increase remain unclear. This study examines the relationship between elevated prepregnancy body mass index (BMI), HDP, and postpregnancy mortality. Study Design: Data came from a 1975-1976 subset (n = 13,722 women) of a population-based cohort. Multiple logistic regression was used to examine the risk of HDP by BMI; age-adjusted Cox proportional hazards models were used to examine survival rates. Results: Overweight (BMI, 25-29.9 kg/m2) and obesity (BMI, ≥30 kg/m2) were associated with increased HDP (odds ratio [OR], 2.82; 95% confidence interval [CI], 2.40-3.31 and OR, 5.51; 95% CI, 4.15-7.31]) and decreased survival (hazard ratio [HR], 1.42; 95% CI, 1.10-1.83 and HR, 2.43; 95% CI, 1.61-3.68), compared with normal weight (BMI, 18.5-24.9 kg/m2). HDP was significantly associated with increased mortality rates for women who survived >15 years (HR, 1.94; 95% CI, 1.42-2.67]; HR adjusted for BMI, 1.65; 95% CI, 1.19-2.79]). A greater increase in risk of death after HDP was seen in the overweight women (HR, 1.86; 95% CI, 1.07-3.20) and obese women (HR, 2.90; 95% CI, 1.28-6.58), compared with normal weight women (HR, 1.26; 95% CI, 0.74-2.14). Conclusion: Elevated prepregnancy BMI is associated with increased risk of HDP, which are in turn is associated with increased long-term maternal mortality rates. This association between HDP and mortality rates increases with elevated prepregnancy BMI.",

keywords = "body mass index, hypertensive disorders of pregnancy, maternal mortality",

author = "Samuels-Kalow, {Margaret E.} and Funai, {Edmund F.} and Catalin Buhimschi and Errol Norwitz and Mary Perrin and Ronit Calderon-Margalit and Lisa Deutsch and Ora Paltiel and Yechiel Friedlander and Orly Manor and Susan Harlap",

note = "Funding Information: Supported by a summer research grant from National Institutes of Health–National Heart, Lung and Blood Institute through the Office of Student Research, Yale University School of Medicine (M.E.S-K.); by the National Center for Research Resources, RR15536-05 (E.F.F.); and by National Alliance for Research on Schizophrenia and Depression and the National Cancer Institute (2R01CA-080197; S.H.). ",

year = "2007",

month = nov,

doi = "10.1016/j.ajog.2007.04.043",

language = "אנגלית",

volume = "197",

pages = "490.e1--490.e6",

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issn = "0002-9378",

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Samuels-Kalow, ME, Funai, EF, Buhimschi, C, Norwitz, E, Perrin, M, Calderon-Margalit, R, Deutsch, L, Paltiel, O, Friedlander, Y, Manor, O & Harlap, S 2007, 'Prepregnancy body mass index, hypertensive disorders of pregnancy, and long-term maternal mortality', American Journal of Obstetrics and Gynecology, vol. 197, no. 5, pp. 490.e1-490.e6. https://doi.org/10.1016/j.ajog.2007.04.043

TY - JOUR

T1 - Prepregnancy body mass index, hypertensive disorders of pregnancy, and long-term maternal mortality

AU - Samuels-Kalow, Margaret E.

AU - Funai, Edmund F.

AU - Buhimschi, Catalin

AU - Norwitz, Errol

AU - Perrin, Mary

AU - Calderon-Margalit, Ronit

AU - Deutsch, Lisa

AU - Paltiel, Ora

AU - Friedlander, Yechiel

AU - Manor, Orly

AU - Harlap, Susan

N1 - Funding Information: Supported by a summer research grant from National Institutes of Health–National Heart, Lung and Blood Institute through the Office of Student Research, Yale University School of Medicine (M.E.S-K.); by the National Center for Research Resources, RR15536-05 (E.F.F.); and by National Alliance for Research on Schizophrenia and Depression and the National Cancer Institute (2R01CA-080197; S.H.).

PY - 2007/11

Y1 - 2007/11

N2 - Objective: Recent studies have shown increased maternal mortality rates after hypertensive disorders of pregnancy (HDP), but the reasons for this increase remain unclear. This study examines the relationship between elevated prepregnancy body mass index (BMI), HDP, and postpregnancy mortality. Study Design: Data came from a 1975-1976 subset (n = 13,722 women) of a population-based cohort. Multiple logistic regression was used to examine the risk of HDP by BMI; age-adjusted Cox proportional hazards models were used to examine survival rates. Results: Overweight (BMI, 25-29.9 kg/m2) and obesity (BMI, ≥30 kg/m2) were associated with increased HDP (odds ratio [OR], 2.82; 95% confidence interval [CI], 2.40-3.31 and OR, 5.51; 95% CI, 4.15-7.31]) and decreased survival (hazard ratio [HR], 1.42; 95% CI, 1.10-1.83 and HR, 2.43; 95% CI, 1.61-3.68), compared with normal weight (BMI, 18.5-24.9 kg/m2). HDP was significantly associated with increased mortality rates for women who survived >15 years (HR, 1.94; 95% CI, 1.42-2.67]; HR adjusted for BMI, 1.65; 95% CI, 1.19-2.79]). A greater increase in risk of death after HDP was seen in the overweight women (HR, 1.86; 95% CI, 1.07-3.20) and obese women (HR, 2.90; 95% CI, 1.28-6.58), compared with normal weight women (HR, 1.26; 95% CI, 0.74-2.14). Conclusion: Elevated prepregnancy BMI is associated with increased risk of HDP, which are in turn is associated with increased long-term maternal mortality rates. This association between HDP and mortality rates increases with elevated prepregnancy BMI.

AB - Objective: Recent studies have shown increased maternal mortality rates after hypertensive disorders of pregnancy (HDP), but the reasons for this increase remain unclear. This study examines the relationship between elevated prepregnancy body mass index (BMI), HDP, and postpregnancy mortality. Study Design: Data came from a 1975-1976 subset (n = 13,722 women) of a population-based cohort. Multiple logistic regression was used to examine the risk of HDP by BMI; age-adjusted Cox proportional hazards models were used to examine survival rates. Results: Overweight (BMI, 25-29.9 kg/m2) and obesity (BMI, ≥30 kg/m2) were associated with increased HDP (odds ratio [OR], 2.82; 95% confidence interval [CI], 2.40-3.31 and OR, 5.51; 95% CI, 4.15-7.31]) and decreased survival (hazard ratio [HR], 1.42; 95% CI, 1.10-1.83 and HR, 2.43; 95% CI, 1.61-3.68), compared with normal weight (BMI, 18.5-24.9 kg/m2). HDP was significantly associated with increased mortality rates for women who survived >15 years (HR, 1.94; 95% CI, 1.42-2.67]; HR adjusted for BMI, 1.65; 95% CI, 1.19-2.79]). A greater increase in risk of death after HDP was seen in the overweight women (HR, 1.86; 95% CI, 1.07-3.20) and obese women (HR, 2.90; 95% CI, 1.28-6.58), compared with normal weight women (HR, 1.26; 95% CI, 0.74-2.14). Conclusion: Elevated prepregnancy BMI is associated with increased risk of HDP, which are in turn is associated with increased long-term maternal mortality rates. This association between HDP and mortality rates increases with elevated prepregnancy BMI.

KW - body mass index

KW - hypertensive disorders of pregnancy

KW - maternal mortality

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Prepregnancy body mass index, hypertensive disorders of pregnancy, and long-term maternal mortality

Abstract

Bibliographical note

Keywords

UN SDGs

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