185599 Association of Hypertensive Disorders of Pregnancy (HDP) with Obesity and Prematurity in an Inner-City Population

Monday, October 27, 2008: 10:30 AM

Noor Afshan Sabzposh, MD, MPH , Department of Obstetrics & Gynecology, J. N. Medical College, AMU, Aligarh, India, Aligarh, India
Karen Benker, MD/MPH , Department of Preventive Medicine, SUNY Downstate Medical Center, Brooklyn, NY
Charles H. Bowers Jr., MD , Department of Obstetrics and Gynecology, Kings County Hospital Center, Brooklyn, NY
Michael A. Joseph, PhD, MPH , Department of Preventive Medicine, SUNY Downstate Medical Center, Brooklyn, NY
Background: Hypertensive Disorders of Pregnancy (HDP) complicate between 6-8% of all pregnancies and have been linked to high rates of maternal morbidity and mortality, premature births, and perinatal mortality. This study aimed to examine the association of maternal obesity and infant prematurity with HDP in an inner-city NY hospital patient population.

Methods: In a case–control study we reviewed medical records of women who delivered singleton babies at an inner-city NY hospital serving a highly diverse minority population during 2005. Cases (n= 80) with a discharge diagnosis of antepartum hypertension were compared to 84 randomly selected women with normal singleton pregnancies (controls).

Results: There were no case-control differences in maternal age, ethnicity, or place of birth. Nulliparity was more common in cases (62.5%) than controls (39.3%) (p=0.004). In comparison to controls, cases were also more likely to be obese or morbidly obese (45% vs. 26.19%, p=0.004); experience more preterm deliveries (62.3% vs.39.3%, p=0.004); have a shorter gestational age (37 weeks vs. 41 weeks, p=0.002); and have higher rates of cesarean sections (38.8% vs.16.7%, p=0.001). These relationships persisted in multivariable logistic regression analyses.

Conclusion: In this inner-city hospital patient population positive association were found between HDP and maternal overweight/obesity, preterm deliveries and cesarean section rate. Our findings have serious public health implications as obesity prevalence continues to rise in the U.S. A resulting increase in the incidence of HDP and premature births may dramatically affect health disparities. Policies and programs promoting healthy pre-conceptual weight may improve both maternal and fetal outcomes.

Learning Objectives:
1. To recognize the relationship of obesity and over weight with hypertensive diseases of pregnancy (HDP) 2. To recognize the relationship of HDP with prematurity of infants

Keywords: Obesity, Pregnancy

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have done this research as a part of my MPH practicum.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.