(629) Rates of Preeclampsia in Subsequent Pregnancies by BMI

Objective: To assess whether body mass index (BMI) impacts rates of preeclampsia amongst pregnant persons with a history of preeclampsia in the previous pregnancy.

Study Design: A retrospective cohort study of two consecutive births in California between 2000-2012 among pregnant persons who had a history of preeclampsia in the index pregnancy. We included singleton, non-anomalous index pregnancies from gestational ages 23-42 weeks. We assessed rates of preeclampsia in the second pregnancy by race/ethnicity, age, BMI, educational attainment and insurance type in chi-squared analysis. We conducted a multivariable logistic regression for repeat cases of preeclampsia by BMI adjusting for race/ethnicity, age, education, and insurance type as potential confounders. Pre-pregnancy BMI was stratified into Underweight ( < 18.5), Normal (18.5-24.9), Overweight (25-39.9) and Obesity Class I (30-34.9), Obesity Class II (35-39.9) and Obesity Class III ( >40).

Results:

There were 22,096 births that met our inclusion criteria. Of those, 3,908 had preeclampsia in the subsequent pregnancy. Of those with preeclampsia in the second pregnancy, the majority (28%) had a BMI within the Overweight category, compared to the majority of those who did not have a repeat case of preeclampsia who fell within the Normal category (34%). In our multivariable regression, compared to those with a Normal BMI, pregnant persons with any BMI >25 had increased odds of preeclampsia in a subsequent pregnancy. Those with a BMI >40 had the highest odds of preeclampsia in a subsequent pregnancy (aOR 1.96 95%CI 1.72-2.23).


Conclusion: Among patients who have had preeclampsia in a prior pregnancy, higher pre-pregnancy BMI was associated with increased odds of having preeclampsia in the subsequent pregnancy.