Interpregnancy Weight Change and Hypertension during Pregnancy: A Systematic Review and Meta-analysis
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OBJECTIVE:To synthesize evidence regarding the association between interpregnancy weight change and hypertensive disorders of pregnancy.DATA SOURCES:MEDLINE, EMBASE, Cochrane Library, Web of Science, and ClinicalTrials.gov databases were systematically searched from the databases' interception until April 2019. Search strategy included the terms: "interpregnancy," "intergestational," "hypertension" and "hypertensive disorders."METHODS OF STUDY SELECTION:Studies that assessed the relationship between interpregnancy weight change and hypertensive disorders of pregnancy were included. Twelve studies and 415,605 women were included in this systematic review and meta-analysis. We used Mendeley reference manager during the review process. Odds ratios (ORs) for the most adjusted models reported by the included articles and the corresponding 95% CIs were calculated. The no weight change category defined by each study was used as the reference category.TABULATION, INTEGRATION, AND RESULTS:Overall, there was an increased risk of hypertensive disorders of pregnancy associated with interpregnancy weight gain (OR 1.37; 95% CI 1.21-1.53; I2=62.1%; P<.001). Additionally, interpregnancy weight loss was associated with lower risk of developing hypertensive disorders of pregnancy (OR 0.87; 95% CI 0.75-0.99; I2=54.9%; P=.01), Finally, meta-regression showed that interpregnancy weight gain was associated with a graded increase in the risk of hypertensive disorders of pregnancy.CONCLUSION:This systematic review and meta-analysis provides evidence that interpregnancy weight gain is associated with an increased risk of hypertensive disorders of pregnancy, gestational hypertension, and preeclampsia.SYSTEMATIC REVIEW REGISTRATION:PROSPERO, CRD42018103002. © 2019 by the American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.
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