Diabetes Obes Metab. 2025 Nov 3. doi: 10.1111/dom.70205. Online ahead of print.
ABSTRACT
AIMS: Gestational hypertension (GH) (new-onset pregnancy hypertension without multisystem preeclampsia features) is associated with an increased risk of long-term cardiometabolic disease. However, early postpartum metabolic trends contributing to these adverse outcomes have been under-investigated. This sub-study aimed to characterise body composition and cardiometabolic parameters in the early years after GH.
MATERIALS AND METHODS: This longitudinal sub-study of the Postpartum Physiology, Psychology and Paediatric cohort study assessed women 6 months (n = 23) and 2 years (n = 14) after GH versus normotensive pregnancy (n = 118). Anthropometry, body composition via bioelectrical impedance analysis, serum biochemistry and metabolic syndrome rates were assessed.
RESULTS: Six months after GH, women had lower rates of breastfeeding and markedly higher systolic and diastolic blood pressures, weight (81.4 kg vs. 63.5 kg, p < 0.001), obesity rates (52% vs. 18%, p < 0.001) and percent fat mass (43.2 ± 7.1% vs. 35.7 ± 9.4%, p < 0.001) compared to controls. These women also had lower high-density lipoprotein cholesterol levels and higher triglyceride, insulin and homeostatic model assessment of insulin resistance levels (1.94 [1.22-3.80] vs. 0.97 [0.62-1.43], p < 0.001). These metabolic differences persisted at 2 years postpartum, in addition to higher low-density lipoprotein cholesterol levels (2.7 [2.4-3.2] mmol/L vs. 2.3 [1.9-2.8] mmol/L, p = 0.04, q = 0.07). Metabolic syndrome rates were also higher (36% vs. 4%, p = 0.001). Percent fat mass, waist-to-hip ratio and total cholesterol improved for all women over time.
CONCLUSIONS: Evidence of cardiometabolic dysfunction, including obesity, percent fat mass, dyslipidaemia and markers of insulin resistance, was present at 6 months after GH. By 2 years postpartum, over one-third of these women meet metabolic syndrome criteria. Further studies are required to characterise targets for early postpartum intervention to mitigate future cardiometabolic health outcomes.
PMID:41178684 | DOI:10.1111/dom.70205
