Objective This study aimed to identify those factors in the non-pregnant st
ate that distinguished women who developed pre-eclampsia from those who had
normotensive pregnancies.
Design and setting This was a retrospective analysis of anthropometry, bloo
d pressure, biochemical and haematological variables in 62 women with pre-e
clampsia and 84 normotensive pregnant women who took part in studies of the
pathophysiology of pre-eclampsia. Pregnant volunteers were seen, after adm
ission to hospital or in the outpatient clinic, and followed-up at 6 weeks
and 6 months post-partum in the outpatient clinic or their home.
Participants Proteinuric pre-eclampsia was defined as blood pressure greate
r than or equal to 140/90 mmHg with proteinuria of at least 300 mg/24 h aft
er 20 weeks gestation, in women with no history of hypertension and whose b
lood pressure returned to normal levels by 6 months post-partum Normotensiv
e pregnancy was defined as blood pressure <130/90 mmHg without proteinuria.
Main outcome measures The primary outcome measures were blood pressure, bod
y mass index (BMI), triglycerides, total cholesterol, low density lipoprote
in (LDL) and high density lipoprotein cholesterol and markers of severity o
f pre-eclampsia.
Results Regardless of parity, women with pre-eclampsia had elevated BMI bef
ore, during and after pregnancy compared with women who had normotensive pr
egnancies. Triglycerides were significantly elevated in women who had pre-e
clampsia both before and after delivery, while total and LDL cholesterol we
re elevated significantly at both visits after delivery. Systolic and diast
olic blood pressure, which by definition were elevated antepartum in women
with pre-eclampsia, remained higher at post-partum visits compared with wom
en who had normotensive pregnancies. Women with pre-eclampsia reported a gr
eatly increased frequency of both maternal hypertension and pre-eclampsia.
Markers of severity of pre-eclampsia, which normalized by 6 months postpart
um, included plasma creatinine, uric acid, albumin, endothelin 1 and urinar
y protein, 2,3, dinor-6-keto-PGF(1 alpha), blood platelet and neutrophil co
unts.
Conclusion The relative elevation of blood pressure, BMI and lipids in the
non-pregnant state are features of the metabolic syndrome and may be import
ant sensitizing factors contributing to the pathogenesis of pre-eclampsia.
A familial predisposition to pre-eclampsia may operate partly through these
mechanisms. J Hypertens 1999, 17:1307-1315 (C) Lippincott Williams & Wilki
ns.