Associations Between Pre-pregnancy Body Mass Index,Serum CA125 And Risk For Preeclampsia,Clinical Phenotypes

Objective and SignificanceObesity is a global epidemic.Previous studies have demonstrated a link between Obesity and pre-eclampsia(PE).However,the relationship between pre-pregnancy BMI and the clinical phenotype of PE is not clear.As a traditional marker of ovarian carcinoma,CA125 has been proved to be correlated with cardiovascular diseases in recent years.The present work aimed to investigate the correlation between prepregnancy BMI and preeclampsia clinical phenotype,as well as association bentween CA125 and PE.MethodsThe finding of this paper is from Shenzhen Cohort Study.It prospectively recruited pregnant women who was singletons and documented at 6-8 weeks gestation.Their weight at 6-8 weeks of gestation was recorded as pre-pregnancy weight.All The subjects were divided into four groups according to Pre-pregnancy body mass index(ppBMI).ppBMI were categorized as underweight(BMI<18.5),normal(18.5 ≤ BMI<24),overweight(24.0 ≤ BMI<28)and obesity(BMI≥28.0).All the subjects were surveyed by basic questionnaire.Maternal outcomes(liver,renal,and coagulation function,the occurrence of preeclampsia)and neonatal outcomes(birth weight,Apgar score and neonatal intensive care unit admission)were recorded.We randomly selected 59 PE women in cohord,match with normal blood pressure women.Serum CA125 were detected in the two groups.ResultsIn this study,42,427 women were enrolled for analysis.The crude incidence rates for preeclampsia were 1.55%,and 0.61%,1.44%,2.62%and 6.22%for pre-pregnancy underweight,normal,overweight and obesity groups,respectively.After adjustment for age,parity,educational level,history of preeclampsia,and ET-IVF compared with normal group,the adjusted odds ratio(OR)for developing early-onset preeclampsia(EOP)was 0.57(95%CI:0.29-1.02)for underweight,1.03(95%CI:0.65～1.56)for overweight and 2.15(95%CI:1.03～4.02)for obesity groups.The OR for developing late-onset preeclampsia(LOP)was 0.50(95%CI:0.33-0.72)for underweight,1.57(95%CI:1.23-1.99)for overweight and 4.25(95%CI:3.00-5.91)for obesity groups.The OR for preeclampsia without severe features was 0.54(95%CI:0.30～0.89),1.40(95%CI:0.97～1.99)and 5.11(95%CI:3.22～7.84)for underweight,overweight and obesity groups,respectively.The OR for severe preeclampsia was 0.51(95%CI:0.33～0.75),1.42(95%CI:1.10～1.83)and 2.97(95%CI:1.95～4.38)for underweight,overweight and obesity groups,respectively.The neonate birth weight in women with preeclampsia were 2420g(1602～2845g),2435g(1692～3030g),2540g(1922～3132g),and 2950g(2050～3360g)for underweight,normal,overweight and obesity groups,respectively.The neonate birth weight in obesity group is heavier than that in normal group(p<0.05).The incidence rates of large for gestational age(LGA)in preeclampsia were 0.00%,3.32%,7.25%,17.5%for underweight,normal,overweight and obesity groups,respectively.The incidence rates of LGA in obesity group is higher than that in normal group(p<0.001).Obesity group had higher levels of serum creatinine(p<0.05),blood urea nitrogen(p<0.05)and plasma plasminogen(p<0.001)than normal group.Serum CA125 level of preeclampsia women was significantly increased,compared with normal blood pressure group,(P<0.05).ConclusionsPre-pregnancy obesity is an independent risk factor preeclampsia.Obesity related PE is more likely associated with LOP and LGA.The influence of organs in obesity suffering PE is mainly in renal function and blood coagulation function.Serum CA125 may play a role in the development of preeclampsia.