Maternal Adiposity and Energy Balance After Normotensive and Preeclamptic Pregnancies

• Published in: The journal of clinical endocrinology and metabolism Vol. 106; no. 8; pp. e2941 - e2952
• Main Authors: McLennan, Sarah L, Henry, Amanda, Roberts, Lynne M, Siritharan, Sai S, Ojurovic, Melissa, Yao, Amanda, Davis, Gregory K, Mangos, George, Pettit, Franziska, Brown, Mark A, O’Sullivan, Anthony J
• Format: Journal Article
• Language: English
• Published: US Oxford University Press 01.08.2021
• Subjects: Adipose tissue; Adiposity - physiology; Adult; Analysis; Blood Pressure - physiology; Body composition; Body fat; Clinical s; Cross-Sectional Studies; Energy; Energy balance; Energy expenditure; Energy intake; Energy Intake - physiology; Energy Metabolism - physiology; Female; Food intake; High density lipoprotein; Humans; Insulin resistance; Insulin Resistance - physiology; Medical research; Medicine, Experimental; Metabolism; Physiological aspects; Postpartum; Postpartum period; Postpartum Period - metabolism; Pre-eclampsia; Pre-Eclampsia - metabolism; Preeclampsia; Pregnancy; Pregnancy complications; Pregnant women; Womens health; Australia; energy intake; energy balance; preeclampsia; energy expenditure; cardiovascular disease risk; fat mass
• ISSN: 0021-972X; 1945-7197
• DOI: 10.1210/clinem/dgab223

Abstract Background Preeclampsia is a major pregnancy complication associated with long-term maternal cardiometabolic disease. Research generally is focused on metabolic and pathophysiological changes during pregnancy; however, there is much less focus on the early postpartum period in subjects who suffered preeclampsia. The aim of this study was to (1) characterize energy intake and expenditure 6 months following normotensive and preeclamptic pregnancies and (2) examine associations between energy balance, body composition, insulin resistance measures (HOMA-IR), and clinical characteristics. Design A cross-sectional study 6 months following normotensive (n = 75) and preeclamptic (n = 22) pregnancies was performed. Metabolic measurements included anthropometrics measures, body composition via bioelectrical impedance analysis, 24-h energy expenditure via SenseWear Armbands, energy intake via a 3-day food diary, and serum metabolic parameters. Results Six months following preeclampsia, women had a significantly higher weight (77.3 ± 20.9 kg vs 64.5 ± 11.4 kg, P = 0.01), fat mass percentage (FM%; 40.7 ± 7.4% vs 34.9 ± 8.1%, P = 0.004), and insulin resistance (HOMA-IR 2.2 ± 1.5 vs 1.0 ± 0.7, P = 0.003), as well as reduced HDL levels (1.5 ± 0.4 mmol/L vs 1.8 ± 0.4 mmol/L, P = 0.01) compared to normotensive women. Women post-preeclampsia had lower activity-related energy expenditure (P = 0.02) but a decreased total energy intake (P = 0.02), leading to a more negative energy balance compared to their normotensive counterparts (−1942 kJ/24 h vs −480 kJ/24 h, P = 0.02). Conclusion Increases in insulin resistance and FM%, reduced high-density lipoprotein, and more sedentary lifestyles characterize the postpartum period following preeclamptic compared with normotensive pregnancies. Early post-preeclampsia interventions, such as lifestyle behavior change, should be implemented and assessed to determine whether they reduce long-term cardiometabolic risk in women who experienced preeclampsia during pregnancy.