Role of maternal subcutaneous fat thickness in the prediction of gestational hypertension/pre-eclampsia

Pre-eclampsia is one of the leading causes for increased morbidity and mortality for mothers and infants. Among the various risk factors identified to be associated with pre-eclampsia, obesity is the most important factor. Till date BMI has been used to measure obesity. This study was done to find correlation between maternal abdominal subcutaneous fat thickness and development of gestational hypertension/pre-eclampsia and to find a cut-off value of subcutaneous fat thickness for prediction of risk of developing gestational hypertension/pre-eclampsia.
Method: 200 women with live singleton pregnancy of 16-18 weeks gestation were included in the study after obtaining written informed consent and applying exclusion criteria. BMI, BP at 16-18 weeks and at 20-24 weeks was measured. Gestational hypertension/pre-eclampsia was diagnosed when BP was >140/90 mm of hg. Maternal abdominal subcutaneous thickness was measured by ultrasonography. Data were entered into MS excel sheet and analysed.
Results: Mean BMI and mean ASCFT in women who developed gestational hypertension/pre-eclampsia (25.75 ± 3.28 kg/m2and 15.57 ± 2.95 mm respectively) were significantly more than in normotensive women (22.84 ± 2.93 kg/m2and 12.05 ± 2.92 mm respectively). ROC curve analysis showed that ASCFT above 15.7 mm (AUC=0.801) predicted gestational hypertension/pre-eclampsia with a sensitivity of 62.5% and specificity of 86.9% and Youden index of 0.49. Using 15.7 mm cut -off value for ASCFT, the odd ratio of gestational hypertension/pre-eclampsia was 11.67 (95% CI 4.56-29.8492, p <0.0001).
Conclusion: Ultrasonographic measurement of SCFT will help us to identify women at high risk of developing gestational hypertension/pre-eclampsia.