RISK-FACTORS FOR PREECLAMPSIA AMONG ZIMBABWEAN WOMEN - MATERNAL ARM CIRCUMFERENCE AND OTHER ANTHROPOMETRIC MEASURES OF OBESITY

Maternal pre-pregnancy obesity is a risk factor for preeclampsia (prot einuric hypertension in pregnancy) among North American and European w omen. We studied the relationship between maternal obesity and risk of pre-eclampsia among Zimbabwean women. A case-control study was conduc ted at Harare Maternity Hospital, Harare, Zimbabwe, between June 1995 and April 1996. Study participants were 144 women with pre-eclampsia a nd 194 normotensive women serving as controls. Maternal weight, height and mid-arm circumference were measured and recorded during study par ticipants' postpartum hospital admission. Maternal mid-arm circumferen ce, considered to be relatively stable during pregnancy among women of developing countries, was used as the primary indicator of maternal p re-pregnancy obesity. Logistic regression procedures were used to esti mate odds ratios and 95% confidence intervals. There were linear trend s in risk of preeclampsia with increasing mid-arm circumference, incre asing weight and increasing body mass index. After adjusting for poten tial confounding factors, women in the highest quintile for mid-arm ci rcumference (28-39 cm) were 4.4 times more likely to have had their pr egnancy complicated by pre-eclampsia than women in the lowest quintile (21-23 cm). Odds ratios of similar magnitude were observed for the ot her anthropometric measures. To our knowledge, this is the first study to demonstrate a positive association between maternal obesity and pr e-eclampsia risk in a black African population. Biological mechanisms thought to explain this relatively consistent epidemiological finding include endothelial cell injury, possibly resulting from hyperlipidaem ia.