Signs of high blood pressure during pregnancy and treatment
Detailed results from Australia show that even with a reduced cholesterol profile, women who are obese during pregnancy have the strongest risk of developing high blood pressure (high blood pressure) over time.
While obese pregnant women are not more likely to become hypertensive than others, they are more likely to die from hypertension.
By rising amounts of a key fatty acid in their bodies, pregnant women also seem to have faster blood pressure.
The findings were published today in the journal BMC Medicine.
British Columbia Health authorities (BCHDA) - a powerful public health authority in the largest population-based study in the world that involves 75 percent of pregnant women in Australia -- and a group of clinicians in Kaiser Permanente's largest medical center, Kaiser Permanente Western Washington -- have taken pioneering steps in Canada and the United States by making ketoacidosis, which is the most common cause of obesity during pregnancy, a target.
Ketoacidosis, a condition that can be caused by elevated blood sugar, is a common complication of hypertension and a leading predictor of continued hypertension after a women's pregnancy.
They show in the multicentre study that for women who suffer from normal blood sugar and ketoacidosis, an average reduction in insulin resistance (FRA) was equivalent to:
losing around 80 percent of their baby weight.
interventions include a home exercise program that helps deplete blood sugar levels but also includes calorie consumption.
'Our findings provide good news and support for using ketoacidosis to help women during pregnancy,' says Dr. Sarah Baumstaudt, AHA; and vice president of partnerships and partnerships, BCHDA.
"When we measured ketoacidosis at birth, fetal maturation was not altered, but we found a number of other adverse outcomes," says Dr. Amanda Hankin, HMO-RWW clinical lead, Kaiser Permanente Pacific's Medical Center, Oakland and President, Kaiser Permanente Pacific Affiliation of New York & Northern California.
"These include maternal anemia, acute hypertension, low birth weight, gestational diabetes, and birth to macrosomia, which is often high-risk for future high blood pressure.
"Because ketoacidosis is a widespread complication of major birth defects and because it is often linked to fetal macrosomia, we also concluded that maternal obesity is a risk factor to deliver small babies."
The total pregnant weight, gestational BMI, gestational to gestational, baby size (labor to 8 lb 2 oz), gestational weight, and gestational BMI from the period of birth to 30 weeks were some of the risk factors in the cohort.
Such pregnancy will often result in macrosomia; high blood pressure and other complications.
Overall pregnancy-related systolic BP elevation was at an approximately 27 percent increase after all mothers' blood sugar levels were lowered.
So, if a mother with a body mass index (BMI) over 30 years old had normal blood sugar levels, she could experience a 25 percent increase in systolic BP.
It is well known that BMI affects the risk of heart disease and that children who are exposed to mothers with overweight or obese status have a higher blood pressure than those who are not.
The study adds to that conclusion.
"There is new evidence that adds urgency to the need to help prevent babies from being born to obese mothers," says Dr. Miranda Bugge, Kaiser Permanente Washington Pregnancy Care manager, and study author.
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The study was supported by the Australian National Public Health Foundation.
KPMG Maternity Australia facilitated the study.
http://www.bmc.gov.au/bmc-med/publications/group/pdfs/here.pdf
http://www.kPMG.com.au/bmcash/monition.html
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