Obesity Does Not Spur Progression of Hypertension


VIENNA — Obesity does not appear to increase the risk for progression to preeclampsia among women with mild gestational hypertension remote from term, John R. Barton, M.D., reported.

Among women with mild gestational hypertension, however, higher body mass index (BMI) is associated with higher birth weights and increased rates of cesarean delivery, Dr. Barton explained during a poster presentation at the 14th World Congress of the International Society for the Study of Hypertension in Pregnancy.

A total of 365 women with mild gestational hypertension and normal BMI (20-25 kg/m

All of the women had singleton pregnancies, according to Dr. Barton of Central Baptist Hospital, Lexington, Ky.

Cesarean deliveries were significantly more common among the obese women (57% vs. 40%).

However, the percentages who progressed to preeclampsia—41% in the obese group vs. 38% in the normal-weight group—were not significantly different between groups, nor were the percentages who developed severe hypertension, HELLP (hemolysis, elevated liver enzymes, and low platelet count) syndrome, abruptio placentae, or eclampsia, Dr. Barton reported at the meeting.

The majority of both obese and nonobese women delivered at 37 weeks or later, whereas the proportions delivered at sooner than 34 weeks—6.3% in the obese group vs. 9.9% of the normal weight women—were not significantly different.

Babies born to obese women had a significantly greater mean birth weight (3,033 g vs. 2,833 g), and a significantly smaller percentage of their babies weighed less than 2,500 g (24% vs. 32%).

Perinatal deaths did not differ between the obese and nonobese groups, according to the study.

This study differs from others that have found an association between obesity and the development of preeclampsia in that most of those data involved women who were originally normotensive, Dr. Barton noted.

These findings support previous recommendations for frequent antepartum monitoring of all women with hypertensive pregnancies, including twice-weekly fetal heart rate testing accompanied by weekly amniotic fluid volume estimation beginning at the time of diagnosis.

In addition, daily kick counts should be considered at the beginning of the third trimester Dr. Barton recommended.

Abnormal nonstress tests or amniotic fluid elevations should be followed by a comprehensive maternal and fetal evaluation, he advised.

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