Increased BMI has a linear association with late-onset preeclampsia: A population-based study

Autoři: Pierre-Yves Robillard aff001;  Gustaaf Dekker aff003;  Marco Scioscia aff004;  Francesco Bonsante aff001;  Silvia Iacobelli aff001;  Malik Boukerrou aff002;  Thomas C. Hulsey aff006
Působiště autorů: Service de Néonatologie, Centre Hospitalier Universitaire Sud Réunion, Saint-Pierre Cedex, La Réunion, France aff001;  Centre d’Etudes Périnatales Océan Indien (CEPOI), Centre Hospitalier Universitaire Sud Réunion, Saint-Pierre Cedex, La Réunion, France aff002;  Department of Obstetrics & Gynaecology, University of Adelaide, Robinson Institute, Lyell McEwin Hospital, Adelaide, Australia aff003;  Department of Obstetrics and Gynaecology, Policlinico of Abano Terme, Padua, Abano Terme, Italy aff004;  Service de Gynécologie et Obstétrique, Centre Hospitalier Universitaire Sud Réunion, Saint-Pierre Cedex, La Réunion, France aff005;  Department of Epidemiology, School of Public Health, West Virginia University, Morgantown, WV, United States of America aff006
Vyšlo v časopise: PLoS ONE 14(10)
Kategorie: Research Article



To investigate the ongoing controversy on the effect of BMI (body mass index) on EOP (early onset preeclampsia) vs LOP (late onset), especially focusing on diabetes and maternal booking/pre-pregnancy BMI as possible independent variables.


18 year-observational cohort study (2001–2018). The study population consisted of all consecutive births delivered at the Centre Hospitalier Universitaire Hospitalier Sud Reunion’s maternity (ap. 4,300 birth per year, only level 3 maternity in the south of Reunion Island, sole allowed to follow and deliver all preeclampsia cases of the area). History of pregnancies, deliveries and neonatal outcomes have been collected in standardized fashion into an epidemiological perinatal data base.


Chronic hypertension and, history of preeclampsia in multigravidas, were the strongest risk factors for EOP. Primiparity, age over 35 years and BMI ≥ 35 kg/m² were rather associated with LOP. In a multivariate analysis with EOP or LOP as outcome variables compared with controls (normotensive), maternal age and pre-pregnancy BMI were independent risk factors for both EOP and LOP (p < 0.001). However, analyzing by increment of 5 (years of age, kg/m² for BMI) rising maternal ages and incidence of preeclampsia were strictly parallel for EOP and LOP, while increment of BMI was only associated with LOP. Controlling for maternal ages and booking/pre-pregnancy BMI, diabetes was not an independent risk factor neither for EOP or LOP.


Metabolic factors, other than diabetes, associated with pre-pregnancy maternal corpulence are specifically associated with LOP. This may be a direction for future researches on the maternal preeclamptic syndrome. This may explain the discrepancy we are facing nowadays where high-income countries report 90% of their preeclampsia being LOP, while it is only 60–70% in medium-low income countries.

Klíčová slova:

Body Mass Index – Hypertensive disorders in pregnancy – Medical risk factors – Obesity – Preeclampsia – Pregnancy


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