Severe pre-eclampsia rose from 0.3% to 1.4% among pregnant women in the United States between 1980 and 2010. An increase which is partly explained by the obesity epidemic.
Severe preeclampsia is on the rise in the USA. Doctors at Columbia University in New York analyzed data from 120 million pregnant American women between 1980 and 2010. They found that the rate of preeclampsia fell from 3.4% in 1980 to 3.8. in 2010. But the authors of this study published in the BMJ found that this rise was due to a sharp increase in the rate of severe preeclampsia which rose from 0.3% to 1.4%, a relative increase of 322%, according to the authors. “Women born in the mid-1970s were exposed to an increased risk of mild preeclampsia, while women born in more recent periods showed an increased risk of severe preeclampsia,” says Prof. Cande V. Ananth, obstetrician gynecologist and study co-author.
Pre-eclampsia is a pathology of pregnancy characterized by an increase in blood pressure (hypertension) occurring at the earliest in the middle of the second trimester (after twenty weeks of amenorrhea) and which is accompanied by an increase in blood pressure. amount of protein present in the urine. This pathology is defined as severe from the moment when the arterial pressure exceeds 160 mm of mercury in systole and 110 mm of mercury in diastole, or if hypertension is accompanied by high proteinuria. The consequences are numerous: abnormal continuous flow of blood between mother and child, abnormal coagulation of the mother’s blood, production of inflammatory molecules in the mother, or even problem of immunological tolerance to the fetus … Complications that can lead to in some cases to termination of pregnancy.
What are the reasons for this increase in severe preeclampsia? Obesity is the first possible explanation. Overweight or obese women are likely to develop insulin resistance, which in turn is implicated as a potent risk factor for preeclampsia. “It is estimated that overweight or obesity causes 15 to 17% of cases of pre-eclampsia”, recall the authors.
“Thus, the increasing prevalence of obesity in the United States has likely resulted in an increasing incidence of severe preeclampsia. Another phenomenon could also have contributed to this increase in incidence, it is the increase in metabolic disorders, such as gestational diabetes, which is also on the rise in the United States.
Another possible explanation, more paradoxical this time, would be the drop in smoking. “While smoking is a risk factor for pregnancy and for the baby,” the authors indicate, “it is associated with a lower risk for pre-eclampsia. Thus, the decrease in the prevalence of smoking in the population may also contribute to an increase in pre-eclampsia ”.
In France, nearly 40,000 women are affected by this pathology. In most cases, follow-up helps prevent serious complications. But in one in 10 cases a severe form occurs.
.
