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In Early Pregnancy, Metabolic Syndrome Increases the Risk of Preterm Birth

Posted: Wednesday, October 28, 2009

Women with metabolic syndrome in early pregnancy have a higher risk for preterm birth, according to study findings.

Dr. Leda Chatzi, of the University of Crete, Greece, and colleagues base this conclusion on their study of 625 women who were members of Crete's mother-child "Rhea" cohort, on whom data was gathered from 2007 to 2009.

The authors defined "metabolic syndrome in early pregnancy" as the presence of three or more or the following at or before 15 weeks' gestation: prepregnancy BMI >30 kg/m2, triglyceride level of 150 mg/dL or more, HDL cholesterol <50 mg/dL, fasting glucose of 100 mg/dL or more, and blood pressure of 130 mmHg or more systolic and 85 mmHg or more diastolic.

The prevalence of the metabolic syndrome in early pregnancy was 3.5%, the researchers report. The risk for preterm birth was nearly tripled in women with metabolic syndrome early in pregnancy (relative risk = 2.93). The highest risk was observed for medically indicated preterm births (RR = 5.13).

Among the components of metabolic syndrome, hypertension was the most significant risk factor (RR = 3.92).

Each elevation of 10 mm Hg in diastolic blood pressure increased the relative risk for preterm birth by 29% and the risk of medically indicated preterm delivery by 67%.

Furthermore, an elevation of 40 mg/dL in total cholesterol increased the relative risk for all preterm births by 24%. For medically indicated preterm births, the relative risk was increased by 52%. Each per unit increase in the LDL/HDL cholesterol ratio increased the relative risk for preterm birth by 19%.

Fetal weight growth restriction was associated with elevated levels of insulin in early pregnancy (RR = 1.14) and elevated levels of diastolic blood pressure (RR = 1.27).

"The complex underlying processes that explain these findings require additional study," Dr. Chatzi and colleagues said. "Further follow-up of this cohort will allow (us to determine) if metabolic syndrome in early pregnancy has, in addition, an effect on cardiovascular risk in childhood and also long-term maternal health risks."

Source: Diabetes In Control: Am J Epidemiol, Oct. 2009;170:829-836.