The role of gestational weight gain in hypertensive disorders of pregnancy: open prospective cohort study

Abstract

Objective: To determine the impact of Gestational Weight gain and Prepregnancy weight as risk factors for Pregnancy Induced Hypertension. Methods: The study was a prospective open cohort study at antenatal clinic of Lagos University Teaching Hospital, Nigeria. Ninety pregnant women who were previously not hypertensive prior to conception and booking were recruited for the study. The blood pressure and weight were done at booking and they were followed up till delivery. The pregnant women had no chronic medical condition. The P value of < 0.05 was considered significant. Results: The frequency of pregnancy induced hypertension was 43 (47.8%). The overall gestational weight gain and prepregnancy weight in pregnant women who developed pregnancy induced hypertension were compared to those without pregnancy induced hypertension. The mean overall weight gain in pregnancy was 11.75 ±4.53kg while mean prepregnancy weight was 65.78±11.52kg. About 37 (41.1%) of the pregnant women had gestational weight gain in the obese and overweight category using the Institute of Medicine classification. The pregnant women who were in the obese and overweight category using the Institute of Medicine classification system were 60.5%. These women had pregnancy induced hypertension while using gestational weight gain greater than 12kg, about 69.8% of woman had pregnancy induced hypertension. Meanwhile 67.4% of pregnant women with prepregnancy, Body Mass Index in the obese and overweight category had pregnancy induced hypertension (Risk ratio (95% confidence interval) 3.66 (1.53-8.75). Conclusion: Gestational weight gain can be used as a screening tool to predict those at risk for pregnancy induced hypertension especially in pregnant women with prepregnant body mass index in the obese and overweight category in resource poor settings.