EARLY-PREGNANCY PERCENT BODY FAT IN RELATION

TO PREECLAMPSIA RISK IN OBESE WOMEN

By:
R.A Delila Tsaniyah
Maghfiroh Rahayu Nindatama
M. Rizky
Galih Cahya Wijayanti
Ahmad Syaukat
Muhammad Fakhri Altyan
Dwi Lestari
Elisha Jethro Solaiman

Advisor:
Dr. dr. Ferry Yusrizal, Sp.OG. K. M.Kes

DEPARTMENT OF OBSTETRIC AND GYNECOLOGY OF FACULTY OF MEDICINE UNSRI

MOHAMMAD HOESIN HOSPITAL PALEMBANG
Outline
General Background
Objective
Description
Materials and methods
Results
Conclusion

Critical PICO
VIA
Appraisal
Background
Preeclampsia is a serious pregnancy complication occurs in 5-8% of pregnancies
in US
Accounts for approximately 15% of all preterm births
Maternal prepregnancy obesity is one of the strongest modifiable risk factors for
preeclampsia
The amount of body fat may help to determine which obese women will
experience preeclampsia
BMI is not an optimal indicator for percent body fat and less reliable in
pregnancy
BIA was used to estimate body fat in pregnancy
Objective
to identify differences of early-pregnancy body fat percentage and body mass
index (BMI) between obese women that experienced preeclampsia and those
who did not.
Materials and Methods
Study Research Statistical
Criteria Measurements
Design Subject Analysis
373 early
pregnancy T-test
Cohort women in
Inclusion: Questionaire
Magee-Womens women in early
Hospital at pregnancy Chi-square
Pittsburgh, PA
Physical
examination
Logistic
Exclusion: women Regression
with hypertension, BIA at 10, 20,
DM, renal disease, and 35 weeks
multiple gestations of gestations
Results
Study participants were aged 23,7 4,1 years; 63% of them were black, and 20% of them were
smokers
The average BMI was 33,1 7,8 kg/m2; most were overweight (20%) or obese (64,1%)
Gestational DM were more common in clinical preeclampsia (6,9%) and research preeclampsia
(14,3%)
Mean gestational age at delivery was 39,5 1,3 weeks (39,0 1,3 weeks for clinical, 38,1 1,7
weeks for research)
There was no significant differences between obesity metrics (BMI, etc) in preeclampsia and
normal pregnancies
Only the highest category of obese women (BMI>40 kg/m2) was the body fat percentage
significantly higher in preeclampsia compared with who did not have preeclampsia
Comparing BMI and percent body fat as predictor of preeclampsia in obese women (BMI> 30
kg/m2)
Higher BMI was associated significantly with higher risk for the research definition of preeclampsia
but not for clinical definition, but not statistically significant any more after adjustment

Percent body fat was associated significantly with higher risk for both research and clinical
definition of preeclampsia
1% increase in body fat, the risk of clinical preeclampsia increased 12% and the risk of preeclampsia
by the research definition increased 24%
The exact mechanism underlying relationship between percent body fat and preeclampsia
remain unidentified

A high degree of
adiposity and
Obesity is
associated
Fetal and maternal associated with
metabolic Preeclampsia
contribution inflammation and
abnormalities
oxidative stress
impair
implantation

Maternal contribution:
predisposing environmental,
genetic
diet, exercise, and fat
distribution
Conclusions
Early pregnancy body fat appears to be important in the pathophysiology condition of
preeclampsia in obese women
Critical Appraisal
PICO
Population Intervention Comparison Outcome

This study No This study Body fat

was done in intervention compared percentage
373 percent body was
outpatient fat in obese associated
clinic of women that significantly
Megee had with
Women preeclampsia increased risk
Hospital in and had not of
Pittsburgh preeclampsia preeclampsia
Validity
Is the research question well-defined that can be answered using this study design?
Yes, this cohort study could answer the research question well

Does the author use appropriate methods to answer their question?

Yes, this study used analytics statistics that is appropriate methods for the purpose of the research

Is the data collected in accordance with the purpose of the research?

Yes, the data was collected for the purpose of research only

Was the randomization list concealed from patients, clinicians, and researchers?
There was no information about randomization in this study

Were the performed interventions described in sufficient detail to be followed by others? Other than
intervention, were the two groups cared for in similar way of treatment?
There was no intervention
Importance

Is this study important?

Yes
It is important to predict preeclampsia and then prevent it from happening
 Applicability

Are your patient so different from these studied that the results may not
apply to them?
Yes
The WHO BMI classification used is not for Asian
Different lifestyle

Is your environment so different from the one in the study that the
methods could not be use there?
Different lifestyle number of obesity could be different different result
But the study methods could be used to do the study in Indonesia
Conclusion
This journal is valid, important, and can be applied for the associated future research.
Thank You