Association of discordant neonatal birth weight and maternal height with risk of preeclampsia: a multi-center retrospective cohort study in China

Abstract

Background: Uteroplacental mismatch contributes to development of preeclampsia, involving of reduced uteroplacental blood supply and/or increased fetoplacental demands. A comprehensive assessment of uteroplacental supply and fetoplacental demands is essential for risk assessment. Maternal height and neonatal weight, which positively related to uteroplacental supply and fetoplacental demands respectively, were shown to associated with altered risk of preeclampsia independently. However, data to comprehensively evaluate associations of neonatal weight and maternal height with the risk of preeclampsia is lacked. Methods: A respective cohort study was conducted among all women delivered at 38 secondary or tertiary maternity centers in 14 cities of China during 2011 to 2012 to assess whether discordant neonatal birth weight and maternal height, such as tall mothers with small for gestational age (SGA) or short mothers with large for gestational age (LGA), was associated with altered risk of preeclampsia. Short and tall heights were defined as ≤10^th and ≥90^th centile of overall maternal height distribution. SGA and LGA were as defined as <10^th and >90^th centile of birth weight for gestational age and sex. Logistic regressions were conducted to estimate these associations. Mothers of average height with appropriate for gestational age (AGA) neonates were regarded as reference. Results: The study enrolled 88,673 mothers with singleton pregnancy. The overall incidence of preeclampsia 2.69%. Tall women with SGA neonates underwent highest incidence (19.18%). Compared with mothers of average height with AGA neonates, women of all heights with SGA neonates were at higher risk of preeclampsia, especially among those of tall height (adjusted OR 10.00, 95%CI 6.06-16.48). In contrast, though LGA infants born to short mothers trended to had higher incidence of preeclampsia (3.24% vs 2.35%), no statistical significance was showed. Conclusions: Those tall women bearing an SGA fetus or short women with LGA fetus had closed associations with preeclampsia. Discordance of maternal height and fetal weight may be a potential indicator for developing preeclampsia.