The association of gestational weight gain with carotid intima-media thickness in correlation with pregnancy outcome and placental assessment: a prospective study.

BACKGROUND

The aim of this study was to investigate the association of gestational weight gain with carotid artery intima-media thickness (IMT) during late pregnancy, and the association with metabolic parameters, pregnancy outcome and placental histological assessment.

METHODS

Pregnant patients admitted with signs of labor were prospectively recruited and categorized into two groups: Group 1 included women with excessive weight gain during pregnancy; Group 2 included women with gestational weight gain within recommended range. IMT of the carotid arteries was measured sonographically. Placental histopathology was assessed by an experienced pathologist.

RESULTS

The study group included 59 women, 32 in group 1 and 27 in group 2. Mean carotid artery IMT was thicker in group 1 compared with group 2 (0.7 vs. 0.6 mm, P=0.028). Metabolic parameters including blood glucose and insulin resistance, using the homeostasis model assessment-insulin resistance (HOMA-IR) were also significantly higher in women with excessive weight gain during pregnancy as compared with group 2 (P=0.026 and P=0.045, respectively). Gestational age at delivery was similar in the two groups, while birthweight and the rate of macrosomia were significantly higher in group 1 than in group 2 (P=0.033 and P=0.014, respectively). Placental lesions consistent with fetal thrombo-occlusive disease were more prevalent in group 1 than in group 2.

CONCLUSIONS

Excessive weight gain during pregnancy is associated with increased IMT of the carotid arteries that correlate with abnormal metabolic parameters, adverse pregnancy outcome and abnormal placental findings.