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Cardiac risk factors and prevention
Original research
Impact of multiple obesity metrics on hypertensive disorders of pregnancy: a meta-analysis and Mendelian randomisation study
  1. Mengting Sun1,
  2. Ming Gao2,
  3. Manjun Luo1,
  4. Tingting Wang1,3,
  5. Xiaorui Ruan1,
  6. Jiapeng Tang1,
  7. Qian Chen1,
  8. Hanjun Liu1,
  9. Liuxuan Li1,
  10. Jiabi Qin1,3
  1. 1 Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
  2. 2 Department of Geriatric Medicine, Center of Coronary Circulation, Xiangya Hospital, Central South University, Changsha, Hunan, China
  3. 3 Hunan Provincial Key Laboratory of Clinical Epidemiology, Changsha, Hunan, China
  1. Correspondence to Professor Jiabi Qin; qinjiabi123{at}163.com

Abstract

Background The relationships between various obesity measures and hypertensive disorders of pregnancy (HDP) remain inadequately explored, and their causal links are not well understood. This study aims to clarify these associations and investigate the mediating role of triglycerides.

Methods We conducted a comprehensive meta-analysis of observational studies alongside Mendelian randomisation (MR) analysis to assess the impact of 10 obesity measures on HDP risk. Additionally, we evaluated the mediating effect of triglycerides.

Results Our meta-analysis revealed significant associations between maternal prepregnancy overweight/obesity and increased risks of gestational hypertension (GH) (overweight: OR=1.98, 95% CI 1.83 to 2.15; obesity: OR=3.77, 95% CI 3.45 to 4.13) and pre-eclampsia (overweight: OR=1.78, 95% CI 1.67 to 1.90; obesity: OR=3.46, 95% CI 3.16 to 3.79). Higher maternal waist circumference (WC) was also linked to increased pre-eclampsia risk (OR=1.45, 95% CI 1.14 to 1.83). MR analyses indicated that each 1-SD increase in genetically predicted obesity measures (whole body fat mass, body fat percentage, trunk fat mass, trunk fat percentage, body mass index, WC, hip circumference) was associated with higher risks of GH and pre-eclampsia. Triglycerides mediated 4.3%–14.1% of the total genetic effect of these obesity measures on GH and pre-eclampsia risks.

Conclusions This study demonstrates that various obesity measures are causally linked to increased HDP risk and highlights the mediating role of triglycerides. These findings could inform clinical practices and public health strategies aimed at reducing HDP through targeted obesity and triglyceride management.

  • Obesity
  • Meta-Analysis
  • Pregnancy
  • Genetic Association Studies
  • Genome-Wide Association Study

Data availability statement

Data are available in a public, open access repository. All data relevant to the study are included in the article or uploaded as supplementary information.

https://doi.org/10.1136/heartjnl-2024-324038

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    Data availability statement

    Data are available in a public, open access repository. All data relevant to the study are included in the article or uploaded as supplementary information.

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    Footnotes

    • Contributors MS and JQ are the guarantors. MS and MG conceived the study, developed the search strategy, screened and analysed data, and wrote the manuscript. ML, XR, TW and JT were involved with data quality assessment, data extraction and data synthesis. HL and LL revised the first manuscript. JQ was responsible for study conception and design, and manuscript revision. The authors read and approved the final manuscript.

    • Funding This work was supported by the National Natural Science Foundation Programme of China (82073653 and 81803313), Hunan Outstanding Youth Fund Project (2022JJ10087), National Key Research and Development Project (2018YFE0114500), China Postdoctoral Science Foundation (2020M682644), Hunan Provincial Science and Technology Talent Support Project (2020TJ-N07), Hunan Provincial Key Research and Development Programme (2018SK2063), Open Project from NHC Key Laboratory of Birth Defect for Research and Prevention (KF2020006), Natural Science Foundation of Hunan Province (2018JJ2551 and 2022JJ40207), Science and Technology Planning Project of Guangdong Province (2020A1414010152), Changsha Municipal Natural Science Foundation (kq2202470).

    • Competing interests None declared.

    • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.