Body composition by dual-energy X-ray absorptiometry in women with previous pre-eclampsia or small-for-gestational-age offspring

Abstract

Objective: To investigate differences in body composition and fat distribution between women with previous pre-eclampsia or small-for-gestational- age (SGA) offspring and those with uncomplicated pregnancies. Design: Cohort study. Setting: Population-based study in a genetically isolated population in the southwest of the Netherlands. Population: Women after pregnancies complicated by pre-eclampsia (n=45), SGA offspring (n=53) and uncomplicated pregnancies (n=106). Methods: Women were compared for body composition and fat distribution variables, assessed by dual-energy X-ray absorptiometry (DXA) and anthropometrics at a mean follow-up time of 10.8 (SD ±5.9) years after pregnancy. Main outcome measures: Total lean and fat mass, android fat mass, gynoid fat mass, android-to-gynoid fat ratio, waist and hip circumference, waist-to-hip ratio. Results: Women with previous pre-eclampsia compared with controls had higher mean total fat mass index (11.5 ± 0.6 versus 9.7 ± 0.4 kg/m2; P = 0.03), lean mass index (15.8 ± 0.3 versus 14.5 ± 0.2 kg/m2; P = 0.001) and body mass index ([BMI]; 28.4 ± 0.8 versus 25.4 ± 0.5 kg/m2; P = 0.005). Their waist circumferences (90.7 ± 2.0 versus 78.5 ± 1.3 cm; P < 0.001) and waist-to-hip ratios (0.86 ± 0.01 versus 0.77 ± 0.01; P < 0.001) were also higher as well as android fat mass (2.8 ± 0.2 versus 2.1 ± 0.1 kg; P = 0.01) and android-to-gynoid fat ratios (0.45 ± 0.02 versus 0.39 ± 0.01; P = 0.02). Mean total fat, lean and BMI was not significantly different between women with previous SGA offspring and controls, yet waist-to-hip ratios (0.83 ± 0.01; P < 0.001) were higher. The observed differences in waist and hip circumference, waist-to-hip ratio and gynoid fat mass could not be attributed to differences in BMI. Conclusion: Women with previous pre-eclampsia or SGA offspring pregnancies compared with those with uncomplicated pregnancies have a preferential fat accumulation in the abdominal over hip region, which may explain, at least partly, their increased cardiovascular risk. © 2009 The Authors.