Chinese Study Data From the Health Examinees Study
[Comment: An American researcher has made this notation: “I would caution against a causal interpretation here as implied in the study’s bottom line: Specifically, the very same factors that lead to late age at FFTP, (i.e., subfertility), may be responsible for pre-eclampsia and downstream metabolic syndrome, diabetes, etc. I believe future research will link all these conditions back to glycine deficiency and the chronic metabolic inflammation it causes.” 17 July 2015]
Introduction: Preeclampsia is one of the most common complications of pregnancy. This pregnancy-specific syndrome, characterized by new-onset hypertension along with proteinuria during gestation, occurs in approximately 3%–8% of all pregnancies worldwide.1
Preeclampsia is generally regarded as a disease of the first pregnancy, but it frequently recurs in later pregnancies.2–4
Preeclampsia increases the risk of maternal mortality, as well as neonatal morbidity and/or mortality.1,5
Furthermore, compelling evidence indicates that the long-term effects of preeclampsia are associated with an increased risk of cardiovascular disease in later life.
Previous studies have suggested that preeclampsia is associated with pathophysiological abnormalities, including endothelial dysfunction and systemic hypertension, and metabolic disorders, such as obesity, insulin resistance, hyperglycemia, and diabetes mellitus.3,6,11–14
The occurrence of a cluster of these perturbations in multiple metabolic pathways is generally known as metabolic syndrome, a condition that is assumed to create a milieu leading to increased risk of cardiovascular disease.15
This means that preeclampsia can increase the risk of metabolic syndrome, which may be an ascendant event of future cardiovascular disease…
Results: … Women diagnosed with preeclampsia tended to be older at first pregnancy (25.4 years vs 24.9 years) and have higher rates of spontaneous (27.9% vs 23.3%) and artificial (71.2% vs 66.3%) abortions; these differences remained statistically significant after adjusting for potential confounders…
A stratified analysis was also conducted to account for the potent effect of late age at first pregnancy (Table 4).
Almost half of the women with a history of preeclampsia and late age at first pregnancy (>35 years) had metabolic syndrome (43.5%); these women had a 4.38-times higher likelihood of metabolic syndrome (95% CI, 1.62–11.9), as evaluated using
the fully adjusted models…
To investigate whether preeclampsia is independently associated with risk of future metabolic syndrome and whether any such primary associations are modified by different ages at first pregnancy.
Based on the Health Examinees Study, a cross-sectional analysis was conducted.
Data of women (n= 49 780) who had experienced at least 1 pregnancy during their lifetime and had never been diagnosed with any metabolic disorder before their pregnancy were analyzed using multiple logistic regression models. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated after adjusting for age, lifestyle characteristics, and reproductive factors.
A stratified analysis was also conducted to estimate the extent of the primary association between preeclampsia and future metabolic syndrome by age at first pregnancy.
Women with a history of preeclampsia had significantly increased odds of developing metabolic syndrome (adjusted OR 1.23; 95% CI, 1.12–1.35), central obesity (adjusted OR 1.36; 95% CI, 1.25 –1.47), elevated blood pressure (adjusted OR 1.53; 95% CI, 1.41–1.67), or elevated fasting glucose (adjusted OR 1.13; 95% CI, 1.03–1.25)
in later life.
In the stratified analysis, women who first became pregnant at ages >35 years and had preeclampsia were found to be at significantly increased likelihood of metabolic syndrome later in life (adjusted OR 4.38; 95% CI,1.62–11.9).
Our findings suggest that preeclampsia increases the risk of metabolic syndrome in later life, and late age at first pregnancy can further exacerbate this risk.
J Epidemiol 2015;25(4):281-288
[Online 7 March 2015, http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4375282/pdf/je-25-281.pdf ]