Skip to main content
Top
Published in: BMC Pregnancy and Childbirth 1/2016

Open Access 01-12-2016 | Research article

Obesity in young age is a risk factor for preeclampsia: a facility based case-control study, northwest Ethiopia

Authors: Mulualem Endeshaw, Fantu Abebe, Solomon Worku, Lalem Menber, Muluken Assress, Muluken Assefa

Published in: BMC Pregnancy and Childbirth | Issue 1/2016

Login to get access

Abstract

Background

Preeclampsia is one of the most commonly encountered hypertensive disorders of pregnancy. For many years, obesity has been suggested to play a role in preeclampsia. However, the hypotheses have been diverse and often revealed inconsistent results. This study has aimed to estimate the effect of obesity and dietary habits on preeclampsia in Bahir Dar City, north-western Ethiopia.

Methods

A facility-based unmatched case-control study was conducted on 453 (151 cases and 302 controls) pregnant women, attending antenatal care or skilled delivery at Bahir Dar City. Data were collected through face to face interviews and measurements of mid-upper-arm circumference (MUAC) at the time of the interviews. Data were cleaned and entered into IBM SPSS version 20 and later analyzed using STATA version 12. Univariate and multivariate logistic regression analyses were employed to estimate the effect of independent variables on preeclampsia. Stratified analysis was conducted to check for presence of confounding and/or effect modification between covariates.

Result

The odds of preeclampsia were higher among obese (MUAC ≥25 cm) women than their leaner counterparts (AOR = 3.33, 95 % CI: 1.87, 5.79). Obesity was also found to have a similar magnitude of risk for late onset preeclampsia (AOR = 3.63, 95 % CI: 1.89, 6.97). When stratified by age, the effect of obesity on overall and late onset preeclampsia was significant among young (age < 35 years) women (COR = 1.81, 95 % CI: 1.11, 2.99) and (COR = 2.09, 95 % CI: 1.16, 3.86), respectively. As the age groups became more homogenous through adjusted stratification, obesity showed a particularly significant effect in women age ≤24 and 25–29 years; (AOR = 2.31, 95 % CI: 1.06, 5.12) and (AOR = 3.66, 95 % CI: 1.37, 10.87) respectively. Similarly, the effect of obesity on late onset preeclampsia was evident among younger women age ≤24 and 25–29 years; (AOR = 3.16, 95 % CI: 1.21, 8.24) and (AOR = 1.98, 95 % CI: 1.16, 3.40) respectively. However, obesity has no significant effect on early onset of preeclampsia (AOR = 1.98, 95 % CI: 0.79, 4.94). On the other hand, compliance to folate supplementation during pregnancy and fruit consumption were associated with reduced risk of preeclampsia.

Conclusion

Obesity in young age was found to be a risk factor for preeclampsia while compliance to folate supplement and adequate fruit consumption were found to be protective against preeclampsia. Promoting healthy life style, including body weight control, consumption of fruits and vegetables, and folate supplementation should be promoted to reduce the risk of preeclampsia.
Literature
1.
go back to reference Sidani M, SIddik-Sayyid MS. Preclampsia, a new perspective. Mej Anesth. 2011;21(2). Sidani M, SIddik-Sayyid MS. Preclampsia, a new perspective. Mej Anesth. 2011;21(2).
2.
go back to reference WHO. WHO Recommendations for Prevention and Treatment of Preeclampsia and Eclampsia. Geneva: WHO; 2011. Contract No.: Document Number|. WHO. WHO Recommendations for Prevention and Treatment of Preeclampsia and Eclampsia. Geneva: WHO; 2011. Contract No.: Document Number|.
3.
go back to reference Roccella EJ. Bethesda, Maryland. Report of the National High Blood Pressure Education Program Working Group on High Blood Pressure in Pregnancy. Am J Obstet Gynecol. 2000;183:1. Roccella EJ. Bethesda, Maryland. Report of the National High Blood Pressure Education Program Working Group on High Blood Pressure in Pregnancy. Am J Obstet Gynecol. 2000;183:1.
4.
go back to reference WHO. Recommendations for Prevention and Treatment of Preeclampsia and Eclampsia. Department of Maternal and Child Health; 2011. WHO. Recommendations for Prevention and Treatment of Preeclampsia and Eclampsia. Department of Maternal and Child Health; 2011.
5.
6.
go back to reference Tessema GA, Tekeste A, Ayele TA. Preeclampsia and associated factors among pregnant women attending antenatal care in Dessie referral hospital, Northeast Ethiopia: a hospital-based study. BMC Pregnancy Childbirth. 2015;15(73). Tessema GA, Tekeste A, Ayele TA. Preeclampsia and associated factors among pregnant women attending antenatal care in Dessie referral hospital, Northeast Ethiopia: a hospital-based study. BMC Pregnancy Childbirth. 2015;15(73).
7.
go back to reference CSA. Ethiopia Mini Demographic and Health Survey 2014. 2014. CSA. Ethiopia Mini Demographic and Health Survey 2014. 2014.
8.
go back to reference Meltzer HM, Brantsæter AL, Nilsen RM, Magnus P, Alexander J, Haugen M. Effect of dietary factors in pregnancy on risk of pregnancy complications: results from the Norwegian Mother and Child Cohort Study. Am J Clin Nutr. 2011;94(suppl):1970S–4.CrossRefPubMedPubMedCentral Meltzer HM, Brantsæter AL, Nilsen RM, Magnus P, Alexander J, Haugen M. Effect of dietary factors in pregnancy on risk of pregnancy complications: results from the Norwegian Mother and Child Cohort Study. Am J Clin Nutr. 2011;94(suppl):1970S–4.CrossRefPubMedPubMedCentral
10.
go back to reference Qiu C, Williams MA, Leisenring WM, Sorensen TK, Frederick IO, Dempsey JC, et al. Family history of hypertension and type 2 diabetes in relation to preeclampsia risk. Am Heart Assoc. 2003;41:408–13. Qiu C, Williams MA, Leisenring WM, Sorensen TK, Frederick IO, Dempsey JC, et al. Family history of hypertension and type 2 diabetes in relation to preeclampsia risk. Am Heart Assoc. 2003;41:408–13.
11.
go back to reference Fanga R, Dawsona A, Lohsoonthorna V, Williamsa MA. Risk factors of early and late onset preeclampsia among Thai women. Asian Biomed. 2009;3(5):477–86. Fanga R, Dawsona A, Lohsoonthorna V, Williamsa MA. Risk factors of early and late onset preeclampsia among Thai women. Asian Biomed. 2009;3(5):477–86.
12.
go back to reference Itoh H, Naohiro K. Obesity and risk of preeclampsia. Med J Obstet Gynecol. 2014;2(2):1024. Itoh H, Naohiro K. Obesity and risk of preeclampsia. Med J Obstet Gynecol. 2014;2(2):1024.
13.
go back to reference Brantsæter AL, Margaretha H, Samuelsen SO, Torjusen H, Trogstad L, Alexander J, et al. A dietary pattern characterized by high intake of vegetables, fruits, and vegetable oils is associated with reduced risk of preeclampsia in nulliparous pregnant Norwegian women. J Nutr. 2009;109:104968. Brantsæter AL, Margaretha H, Samuelsen SO, Torjusen H, Trogstad L, Alexander J, et al. A dietary pattern characterized by high intake of vegetables, fruits, and vegetable oils is associated with reduced risk of preeclampsia in nulliparous pregnant Norwegian women. J Nutr. 2009;109:104968.
14.
go back to reference Cynthia V, Max W. Relationship of twin zygosity and risk of preeclampsia. Am J Obstet Gynecol. 2001;185(4):819–21.CrossRef Cynthia V, Max W. Relationship of twin zygosity and risk of preeclampsia. Am J Obstet Gynecol. 2001;185(4):819–21.CrossRef
15.
go back to reference Torjusen H, Lieblein G, Næs T, Haugen M, Meltzer HM, Brantsæter AL. Food patterns and dietary quality associated with organic food consumption during pregnancy; data from a large cohort of pregnant women in Norway. BMC Public Health. 2012;12:612.CrossRefPubMedPubMedCentral Torjusen H, Lieblein G, Næs T, Haugen M, Meltzer HM, Brantsæter AL. Food patterns and dietary quality associated with organic food consumption during pregnancy; data from a large cohort of pregnant women in Norway. BMC Public Health. 2012;12:612.CrossRefPubMedPubMedCentral
16.
go back to reference ShiWuWen, Josee Champagne, Ruth Rennicks White, Doug Coyle, William Fraser GS, Dean Fergusson, and Mark C. Walker. Effect of Folic Acid Supplementation in Pregnancy on Preeclampsia: The Folic Acid Clinical Trial Study. J Pregnancy. 2013;294312. ShiWuWen, Josee Champagne, Ruth Rennicks White, Doug Coyle, William Fraser GS, Dean Fergusson, and Mark C. Walker. Effect of Folic Acid Supplementation in Pregnancy on Preeclampsia: The Folic Acid Clinical Trial Study. J Pregnancy. 2013;294312.
17.
go back to reference Perni UC, Wikström A-K, Cnattingius S, Villamor E. Interpregnancy change in smoking habits and risk of preeclampsia: a population-based study. Am J Hypertens. 2012;25(3):372.CrossRefPubMed Perni UC, Wikström A-K, Cnattingius S, Villamor E. Interpregnancy change in smoking habits and risk of preeclampsia: a population-based study. Am J Hypertens. 2012;25(3):372.CrossRefPubMed
18.
go back to reference Schoenaker DA, Soedamah-Muthu SS, Mishra GD. The association between dietary factors and gestational hypertension and pre-eclampsia: a systematic review and meta-analysis of observational studies. BMC Med. 2014;12:157.CrossRefPubMedPubMedCentral Schoenaker DA, Soedamah-Muthu SS, Mishra GD. The association between dietary factors and gestational hypertension and pre-eclampsia: a systematic review and meta-analysis of observational studies. BMC Med. 2014;12:157.CrossRefPubMedPubMedCentral
19.
go back to reference Torjusen H, Brantsæter AL, Haugen M, Alexander J, Bakketeig LS, Lieblein G, et al. Reduced risk of pre-eclampsia with organic vegetable consumption: results from the prospective Norwegian Mother and Child Cohort Study. BMJ. 2014;4:e006143. Torjusen H, Brantsæter AL, Haugen M, Alexander J, Bakketeig LS, Lieblein G, et al. Reduced risk of pre-eclampsia with organic vegetable consumption: results from the prospective Norwegian Mother and Child Cohort Study. BMJ. 2014;4:e006143.
20.
go back to reference Morris CD, Jacobson SL, Anand R, Ewell MG, Hauth JC, Curet LB, et al. Nutrient intake and hypertensive disorders of pregnancy: evidence from a large prospective cohort. Am J Obstet Gynecol. 2001;184(4):643–51.CrossRefPubMed Morris CD, Jacobson SL, Anand R, Ewell MG, Hauth JC, Curet LB, et al. Nutrient intake and hypertensive disorders of pregnancy: evidence from a large prospective cohort. Am J Obstet Gynecol. 2001;184(4):643–51.CrossRefPubMed
21.
go back to reference Eiland E, Nzerue C, Faulkner M. Preeclampsia 2012. J Pregnancy. 2012;2012:7.CrossRef Eiland E, Nzerue C, Faulkner M. Preeclampsia 2012. J Pregnancy. 2012;2012:7.CrossRef
22.
go back to reference World Bank. Economic Overview. The world bank, IBRDIDA. 2015. World Bank. Economic Overview. The world bank, IBRDIDA. 2015.
23.
go back to reference WHO. Guideline: Daily iron and folic acid supplementation in pregnant women. World Health Organization; 2012. WHO. Guideline: Daily iron and folic acid supplementation in pregnant women. World Health Organization; 2012.
24.
go back to reference Ververs M-t, Antierens A, Sackl A, Staderini N, Captier V. Which anthropometric indicators identify a pregnant woman as acutely malnourished and predict adverse birth outcomes in the humanitarian context? PLoS One. 2013. Ververs M-t, Antierens A, Sackl A, Staderini N, Captier V. Which anthropometric indicators identify a pregnant woman as acutely malnourished and predict adverse birth outcomes in the humanitarian context? PLoS One. 2013.
25.
go back to reference Mahomed K, Williams MA WG, Jenkins-Woelk L, Mudzamiri S, Longstaff L, Sorensen TK. Risk factors for pre-eclampsia among Zimbabwean women: maternal arm circumference and other anthropometric measures of obesity. Paediatr Perinat Epidemiol. 1998;12(3):253–62.CrossRefPubMed Mahomed K, Williams MA WG, Jenkins-Woelk L, Mudzamiri S, Longstaff L, Sorensen TK. Risk factors for pre-eclampsia among Zimbabwean women: maternal arm circumference and other anthropometric measures of obesity. Paediatr Perinat Epidemiol. 1998;12(3):253–62.CrossRefPubMed
26.
go back to reference Mulualem Endeshaw FA, Melkamu B, Anemaw A. Diet and pre-eclampsia: a prospective multicentre case–control study in Ethiopia. Midwifery. 2015;31:617–24.CrossRefPubMed Mulualem Endeshaw FA, Melkamu B, Anemaw A. Diet and pre-eclampsia: a prospective multicentre case–control study in Ethiopia. Midwifery. 2015;31:617–24.CrossRefPubMed
27.
go back to reference Silva DAS, Petroski EL, Peres MA. Is high body fat estimated by body mass index and waist circumference a predictor of hypertension in adults? A population-based study. Nutr J. 2012;11:112.CrossRefPubMedCentral Silva DAS, Petroski EL, Peres MA. Is high body fat estimated by body mass index and waist circumference a predictor of hypertension in adults? A population-based study. Nutr J. 2012;11:112.CrossRefPubMedCentral
28.
go back to reference Aliyu MH, Luke S, Kristensen S, Alio AP, Salihu HM. Joint effect of obesity and teenage pregnancy on the risk of preeclampsia: a population-based study. J Adolesc Health. 2010;46(2010):77–82.CrossRefPubMed Aliyu MH, Luke S, Kristensen S, Alio AP, Salihu HM. Joint effect of obesity and teenage pregnancy on the risk of preeclampsia: a population-based study. J Adolesc Health. 2010;46(2010):77–82.CrossRefPubMed
29.
go back to reference Derbyshire E. Can anthropometric and body composition measurements during pregnancy be used to predict preeclampsia risk? Curr Womens Health Rev. 2009;5:225–9.CrossRef Derbyshire E. Can anthropometric and body composition measurements during pregnancy be used to predict preeclampsia risk? Curr Womens Health Rev. 2009;5:225–9.CrossRef
30.
go back to reference Spaans F, Pd V, Bakker WW, Hv G, Faas MM. Danger signals from ATP and adenosine in pregnancy and preeclampsia. Am Heart Assoc. 2014;63:1154–60. Spaans F, Pd V, Bakker WW, Hv G, Faas MM. Danger signals from ATP and adenosine in pregnancy and preeclampsia. Am Heart Assoc. 2014;63:1154–60.
31.
go back to reference Sharbaf FR, Dehghanpour P, Shariat M, Dalili H. Caffeine consumption and incidence of hypertension in pregnancy. J Fam Reprod Health. 2013;7:3. Sharbaf FR, Dehghanpour P, Shariat M, Dalili H. Caffeine consumption and incidence of hypertension in pregnancy. J Fam Reprod Health. 2013;7:3.
32.
go back to reference Bakker R, Steegers EA, Obradov A, Raat H, Hofman A, Jaddoe VW. Maternal caffeine intake from coffee and tea, fetal growth, and the risks of adverse birth outcomes: the Generation R Study. Am J Clin Nutr. 2010;91:1691–8.CrossRefPubMed Bakker R, Steegers EA, Obradov A, Raat H, Hofman A, Jaddoe VW. Maternal caffeine intake from coffee and tea, fetal growth, and the risks of adverse birth outcomes: the Generation R Study. Am J Clin Nutr. 2010;91:1691–8.CrossRefPubMed
33.
go back to reference Sibai BM. “Hypertension in pregnancy”. Obstet Gynecol Clin North Am. 1992;19(4):615–32. Sibai BM. “Hypertension in pregnancy”. Obstet Gynecol Clin North Am. 1992;19(4):615–32.
35.
go back to reference Bakker WW, Donker RB, Timmer A, Pampus MG, Son WJ, Aarnoudse JG, et al. Plasma hemopexin activity in pregnancy and preeclampsia. Hypertens Pregnancy. 2007;26:227–39.CrossRefPubMed Bakker WW, Donker RB, Timmer A, Pampus MG, Son WJ, Aarnoudse JG, et al. Plasma hemopexin activity in pregnancy and preeclampsia. Hypertens Pregnancy. 2007;26:227–39.CrossRefPubMed
36.
go back to reference Wen SW, Chen X, Rodger M, et al. “Folic acid supplementation in early second trimester and the risk of preeclampsia”. Am J Obstet Gynecol. 2008;198(1)45.e1–45.e7. Wen SW, Chen X, Rodger M, et al. “Folic acid supplementation in early second trimester and the risk of preeclampsia”. Am J Obstet Gynecol. 2008;198(1)45.e1–45.e7.
37.
go back to reference Yakub M, Iqbal MP, Iqbal R. Dietary patterns are associated with hyperhomocysteinemia in an urban Pakistani population. J Nutr. 2010;140:1261–6.CrossRefPubMed Yakub M, Iqbal MP, Iqbal R. Dietary patterns are associated with hyperhomocysteinemia in an urban Pakistani population. J Nutr. 2010;140:1261–6.CrossRefPubMed
38.
go back to reference Haberg S, London S, Stigum H, Nafstad P, Nystad W. Folic acid supplements in pregnancy and early childhood respiratory health. Arch Dis Child. 2009;94:180–4.CrossRefPubMed Haberg S, London S, Stigum H, Nafstad P, Nystad W. Folic acid supplements in pregnancy and early childhood respiratory health. Arch Dis Child. 2009;94:180–4.CrossRefPubMed
39.
go back to reference Hwang J-Y, Lee J-Y, Kim K-N, Kim H, Ha E-H, Park H, et al. Maternal iron intake at mid-pregnancy is associated with reduced fetal growth: results from Mothers and Children’s Environmental Health (MOCEH) study. BMC Nutr J. 2013;12(1):38.CrossRef Hwang J-Y, Lee J-Y, Kim K-N, Kim H, Ha E-H, Park H, et al. Maternal iron intake at mid-pregnancy is associated with reduced fetal growth: results from Mothers and Children’s Environmental Health (MOCEH) study. BMC Nutr J. 2013;12(1):38.CrossRef
40.
go back to reference McCarthy F, OʼKeeffe L, Khashan A. Association between maternal alcohol consumption in early pregnancy and pregnancy outcomes. Obstet Gynecol. 2013;122:830–7.CrossRefPubMed McCarthy F, OʼKeeffe L, Khashan A. Association between maternal alcohol consumption in early pregnancy and pregnancy outcomes. Obstet Gynecol. 2013;122:830–7.CrossRefPubMed
Metadata
Title
Obesity in young age is a risk factor for preeclampsia: a facility based case-control study, northwest Ethiopia
Authors
Mulualem Endeshaw
Fantu Abebe
Solomon Worku
Lalem Menber
Muluken Assress
Muluken Assefa
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Pregnancy and Childbirth / Issue 1/2016
Electronic ISSN: 1471-2393
DOI
https://doi.org/10.1186/s12884-016-1029-2

Other articles of this Issue 1/2016

BMC Pregnancy and Childbirth 1/2016 Go to the issue