Cardiometabolic health 8–12 years after pre-eclampsia: Role of obesity and gestational diabetes (FINNCARE study)

Abstract

Objective: This study examined the long-term cardiometabolic health in subgroups of pre-eclampsia (PE) to identify individuals who would benefit from targeted cardiovascular screening. Design and main outcome: A cross-sectional cohort. We compared cardiometabolic profile (anthropometrics, body composition, blood biomarkers, and blood pressure) among normotensive control pregnancies (n = 92), de novo PE (n = 156), de novo PE with gestational diabetes mellitus (GDM) (PE + GDM, n = 16), and PE superimposed on chronic hypertension (n = 18). With sensitivity analysis, we compared early-onset PE (EOPE n = 27) and late-onset PE (LOPE n = 165) groups. Results: Cardiometabolic profiles were similar between de novo PE and normotensive groups, except for higher blood pressure in the de novo PE group. Women with PE + GDM and superimposed PE had higher median BMI (30.8 kg/m2, IQR 7.6 and 30.6 kg/m2, IQR 9.6, respectively) and more adiposity than de novo PE and normotensive groups. In the multivariable models, BMI was associated with low-and high-density lipoprotein cholesterol (β = 0.19, 95 % CI: 0.008 to 0.05; β = -0.41, 95 % CI: −0.03 to −0.02, respectively), high-sensitivity C-reactive protein (β = 0.64, 95 % CI: 0.11–0.15), triglyceride (β = 0.52, 95 % CI: 0.03 to 0.05) as well as glucose and insulin concentrations in the whole study population. Women with EOPE had higher low-density lipoprotein and total cholesterol concentrations than women in LOPE and control groups. Conclusions: Women with PE + GDM and with superimposed PE exhibited an adverse cardiometabolic profile characterized by high BMI. This highlights the need for targeted cardiovascular prevention. Women with de novo PE should undergo regular blood pressure monitoring.