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Maternal adipose tissue to early preeclampsia risk detection: Is the time to maternal ultrasound beyond fetal evaluation?
Author(s) -
Silva Rocha Alexandre Da,
Rombaldi Bernardi Juliana,
Matos Salete De,
Cortés Kretzer Daniela,
Carvalhal Schöffel Alice,
Zubaran Goldani Marcelo,
Azevedo Magalhães José Antônio De
Publication year - 2021
Publication title -
journal of obstetrics and gynaecology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 50
eISSN - 1447-0756
pISSN - 1341-8076
DOI - 10.1111/jog.14756
Subject(s) - medicine , adipose tissue , quartile , preeclampsia , obstetrics , body mass index , pregnancy , odds ratio , intra abdominal fat , ultrasound , gynecology , obesity , radiology , visceral fat , insulin resistance , confidence interval , biology , genetics
This study aims to determine the predictive capacity of isolated maternal periumbilical and epigastric fat measurements during pregnancy to hypertensive outcomes. Methods A cohort study was conducted with pregnant women in any trimester and followed until delivery to identify the outcomes of interest, preeclampsia (PE) and gestational hypertension (GH). The predictive capacity of fourth quartile measurements was compared with the first three quartiles of maternal subcutaneous and visceral adipose tissue from the periumbilical site (periumbilical m‐SAT and m‐VAT) ( n = 155) and maternal adipose tissue from the epigastric site (preperitoneal m‐SAT and m‐VAT) ( n = 261). The predictive ability of prepregnant body mass index (BMI) above 30 kg/m 2 for PE and GH was also assessed. Results Fourth quartiles for the periumbilical ultrasound measurements were m‐VAT 52.7 mm and m‐SAT 21.7 mm. Preperitoneal site presents fourth quartiles m‐VAT 15.2 mm and m‐SAT 18.6 mm. Both m‐VAT and m‐SAT maternal periumbilical and preperitoneal sites are unable to predict PE, with the utmost sensitivity attributed to the periumbilical site m‐SAT at 54%. The best PE predictor odds ratio (OR) found was the prepregnant BMI consistent with obesity, with an OR of 3.2 (95% CI 1.1–9.4), whereas the best OR to GH predictor was preperitoneal m‐SAT with 8.9 (95% CI 2.3–34.6). Conclusion PE pathogenic mechanisms related to maternal abdominal adipose tissue include differences in molecular, cytological, and tissue levels not detected by ultrasound in a quantified gray scale assessment. Periumbilical or epigastric m‐VAT use is not able to predict PE during pregnancy.