American Journal of Epidemiology Advance Access originally published online on June 14, 2007
American Journal of Epidemiology 2007 166(4):421-428; doi:10.1093/aje/kwm099
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ORIGINAL CONTRIBUTIONS |
The Association of Hypertensive Disorders of Pregnancy with Weight Gain over the Subsequent 21 Years: Findings from a Prospective Cohort Study
1 Department of Internal Medicine, Royal Brisbane and Women's Hospital, Brisbane, Australia
2 Diamantina Institute, University of Queensland, Brisbane, Australia
3 School of Medicine, University of Queensland, Brisbane, Australia
4 Department of Endocrinology, Mater Health Services, Brisbane, Australia
5 Department of Obstetric Medicine, Mater Health Services, Brisbane, Australia
6 Mater Children's Hospital, Brisbane, Australia
7 School of Population Health, University of Queensland, Brisbane, Australia
8 Department of Social Medicine, University of Bristol, Bristol, United Kingdom
Correspondence to Dr. Leonie K. Callaway, E Floor, Clinical Sciences Building, Royal Brisbane and Women's Hospital, Herston Queensland 4029, Australia (e-mail: l.callaway{at}uq.edu.au).
Received for publication September 26, 2006. Accepted for publication February 21, 2007.
Obesity is an important risk factor for hypertensive disorders of pregnancy, but most cases of hypertensive disorders of pregnancy occur in women of normal weight. There may be predisposing factors to both hypertensive disorders of pregnancy and obesity. To test this hypothesis, the authors compared changes in body mass index (weight (kg)/height (m)2) over time in women with and without hypertensive disorders of pregnancy. They used data from 3,572 women who received antenatal care at a major public hospital in Brisbane, Australia, between 1981 and 1984 and who were followed up for 21 years. A total of 318 women (8.9%) had experienced hypertensive disorders in the index pregnancy, and 233 of them (73.3%) had a baseline body mass index of 
25 kg/m2. After the authors adjusted for all potential confounding factors, they found that women with hypertensive disorders of pregnancy gained on average 1.35 kg/m2 more (95% confidence interval: 0.80 kg/m2, 1.89 kg/m2) in body mass index over 21 years than women without hypertensive disorders of pregnancy. The odds of gaining 
5 kg/m2 were 59% greater for women who experienced hypertensive disorders of pregnancy compared with those who did not (odds ratio = 1.59, 95% confidence interval: 1.24, 2.04). The authors concluded that hypertensive disorders of pregnancy are associated with increased weight gain over 21 years.
body mass index; body weight; hypertension; pre-eclampsia; pregnancy; prospective studies; weight gain; women
Abbreviations: BMI, body mass index; HDP, hypertensive disorders of pregnancy