TY - JOUR
T1 - Gestational diabetes modifies the association between PlGF in early pregnancy and preeclampsia in women with obesity
AU - Vieira, Matias C.
AU - Begum, Shahina
AU - Seed, Paul T.
AU - Badran, Dania
AU - Briley, Annette L.
AU - Gill, Carolyn
AU - Godfrey, Keith M.
AU - Lawlor, Deborah A.
AU - Nelson, Scott M.
AU - Patel, Nashita
AU - Sattar, Naveed
AU - White, Sara L.
AU - Poston, Lucilla
AU - Pasupathy, Dharmintra
AU - UPBEAT Consortium
PY - 2018/7
Y1 - 2018/7
N2 - Objective: To identify clinical and biomarker risk factors for preeclampsia in women with obesity and to explore interactions with gestational diabetes, a condition associated with preeclampsia. Study design: In women with obesity (body mass index ≥ 30 kg/m2) from the UK Pregnancies Better Eating and Activity Trial (UPBEAT), we examined 8 clinical factors (socio-demographic characteristics, BMI, waist circumference and clinical variables) and 7 biomarkers (HDL cholesterol, hemoglobin A1c, adiponectin, interleukin-6, high sensitivity C-reactive protein, and placental growth factor (PlGF)) in the early second trimester for association with later development of preeclampsia using logistic regression. Factors were selected based on prior association with preeclampsia. Interaction with gestational diabetes was assessed. Main outcome measure: Preeclampsia. Results: Prevalence of preeclampsia was 7.3% (59/824). Factors independently associated with preeclampsia were higher mean arterial blood pressure (Odds Ratio (OR) 2.22; 95% Confidence Interval (CI) 1.58–3.12, per 10 mmHg) and lower PlGF (OR 1.39; 95% CI 1.03–1.87, per each lower 1 log2). The association of PlGF with preeclampsia was present amongst obese women without gestational diabetes (OR 1.91; 95% CI 1.32–2.78), but not in those with GDM (OR 1.05; 95% CI 0.67–1.63), p = 0.04 for interaction. Conclusion: The relationship between PlGF and preeclampsia differed in women with obesity according to gestational diabetes status, which may suggest different mechanistic pathways to preeclampsia. Whilst replication is required in other populations, this study suggests that performance of prediction models for preeclampsia should be confirmed in pre-specified subgroups.
AB - Objective: To identify clinical and biomarker risk factors for preeclampsia in women with obesity and to explore interactions with gestational diabetes, a condition associated with preeclampsia. Study design: In women with obesity (body mass index ≥ 30 kg/m2) from the UK Pregnancies Better Eating and Activity Trial (UPBEAT), we examined 8 clinical factors (socio-demographic characteristics, BMI, waist circumference and clinical variables) and 7 biomarkers (HDL cholesterol, hemoglobin A1c, adiponectin, interleukin-6, high sensitivity C-reactive protein, and placental growth factor (PlGF)) in the early second trimester for association with later development of preeclampsia using logistic regression. Factors were selected based on prior association with preeclampsia. Interaction with gestational diabetes was assessed. Main outcome measure: Preeclampsia. Results: Prevalence of preeclampsia was 7.3% (59/824). Factors independently associated with preeclampsia were higher mean arterial blood pressure (Odds Ratio (OR) 2.22; 95% Confidence Interval (CI) 1.58–3.12, per 10 mmHg) and lower PlGF (OR 1.39; 95% CI 1.03–1.87, per each lower 1 log2). The association of PlGF with preeclampsia was present amongst obese women without gestational diabetes (OR 1.91; 95% CI 1.32–2.78), but not in those with GDM (OR 1.05; 95% CI 0.67–1.63), p = 0.04 for interaction. Conclusion: The relationship between PlGF and preeclampsia differed in women with obesity according to gestational diabetes status, which may suggest different mechanistic pathways to preeclampsia. Whilst replication is required in other populations, this study suggests that performance of prediction models for preeclampsia should be confirmed in pre-specified subgroups.
KW - Biomarkers
KW - Gestational diabetes mellitus
KW - Obesity
KW - Preeclampsia
KW - Risk factors
UR - http://www.scopus.com/inward/record.url?scp=85049874056&partnerID=8YFLogxK
U2 - 10.1016/j.preghy.2018.07.003
DO - 10.1016/j.preghy.2018.07.003
M3 - Article
C2 - 30177064
AN - SCOPUS:85049874056
VL - 13
SP - 267
EP - 272
JO - Pregnancy Hypertension
JF - Pregnancy Hypertension
SN - 2210-7789
ER -