Get shorty some BP meds

Women who were preemies run more than twice the average woman's risk of developing gestational hypertension

By Owen Dyer

Aside from having a size disadvantage that can carry on into adulthood, preemies are usually stricken with other shortcomings � atrial septal defects, asthma, learning disabilities, among other things. After getting picked on throughout school, they graduate and hope that the bad luck ends there. Well it doesn't. Women who were born preterm or of low birth weight run more than twice the average woman's risk of developing gestational hypertension (GH) during their first pregnancy, according to a new study from Finland, published in the April issue of Hypertension.

Women who develop GH are likely to have an unfavourable lipid profile and body mass index years later, said the authors. This adds to the growing body of evidence that children born premature or underweight tend to suffer poorer cardiovascular health throughout life.

Dr Anneli Pouta, of the University of Oulu, Finland, and colleagues, examined factors associated with GH or preeclampsia during a first pregnancy in a prospective study of women from the two northernmost provinces of Finland. The women had been followed since their births in 1966.

The researchers measured blood pressure (BP) and collected blood samples in the subjects at age 31. A total of 1,463 of these women had had at least one singleton pregnancy, at an average age of 25. Of these, 45 had been hospitalised with GH (nonproteinuric variety) and 49 with preeclampsia.

Women who were born before gestational week 37 were 2.5 times more likely to develop GH during their first pregnancy. No increased risk was observed for preeclampsia. Women who'd been underweight at birth had twice the normal risk of GH in their first pregnancy. Because the average Finnish baby is a fairly solid specimen, the authors set the bar for underweight at 2.75kg rather than a more usual 2.5kg.

Compared to women with previous normotensive pregnancies, those who had either GH or preeclampsia during their first pregnancy had increased BP at age 31, even after adjustment for body mass index. "Women with GH and preeclampsia also had higher waist circumference, waist/hip ratios, and body mass index, as well as increased serum insulin levels and lower glucose/insulin ratios than women with previous normotensive pregnancy," reported Dr Pouta. Women who'd developed preeclampsia during their first pregnancy had, at age 31, significantly higher BP and insulin levels, and lower glucose/insulin ratios.

Based on these findings, the authors suggest that women with preeclampsia and especially with GH should have their BP measured and controlled after pregnancy. "They should be informed about the increased risk for hypertension in subsequent pregnancies and later in life."

In addition, "women with hypertensive pregnancy should also receive lifestyle counselling aimed at optimizing body weight and to control lipid and glucose levels in the post partum period."