Maternal adiposity measures and hypertensive disorders of pregnancy: a meta-analysis

BACKGROUND: Hypertensive disorders of pregnancy (HDP) are a prevalent complication during pregnancy with significant implications for maternal and perinatal health globally. Maternal obesity is a known risk factor for HDP. This review sought to identify adiposity indicators in early pregnancy that are linked to the development of HDP. METHODS: We conducted a systematic search of the PubMed, Science Citation Index (Web of Science), and Embase databases. Screening and quality evaluation of studies was conducted independently by two reviewers. Both random effects meta-analysis and narrative synthesis were performed. RESULTS: Thirty-one studies were included with a pooled sample of 81,311 women. The meta-analysis showed that the odds of HDP were significantly increased by higher pregnancy measures of adiposity (pre-pregnancy body mass index (OR = 2.14, 95%CI: 1.67-2.75), visceral adipose tissue (OR = 1.79, 95%CI: 1.01-3.16), subcutaneous adiposity thickness (OR = 1.67, 95%CI: 1.36-2.05), waist circumference (OR = 2.20, 95%CI: 1.37-3.54), waist to-hip ratio (OR = 3.08, 95% CI: 1.38-6.87), weight gain (OR = 1.69, 95%CI: 1.42-2.02) and percentage body fat (OR = 1.71, 95%CI: 1.16-2.53)). Epicardial fat thickness was significantly associated with HDP, although limited data were available. CONCLUSIONS: The results of our study highlight the importance of investigating the predictive value of adiposity measures in identifying the risk of HDP to tailor care towards women at the highest risk.