The association of gestational weight gain with carotid intima-media thickness in correlation with pregnancy outcome and placental assessment: a prospective study

BACKGROUND: The aim of this study was to investigate the association of gestational weight gain with carotid artery intima-media thickness (IMT) during late pregnancy, and the association with metabolic parameters, pregnancy outcome and placental histological assessment. METHODS: Pregnant patients admitted with signs of labor were prospectively recruited and categorized into two groups: Group 1 included women with excessive weight gain during pregnancy; Group 2 included women with gestational weight gain within recommended range. IMT of the carotid arteries was measured sonographically. Placental histopathology was assessed by an experienced pathologist. RESULTS: The study group included 59 women, 32 in group 1 and 27 in group 2. Mean carotid artery IMT was thicker in group 1 compared with group 2 (0.7 vs. 0.6 mm, P=0.028). Metabolic parameters including blood glucose and insulin resistance, using the homeostasis model assessment-insulin resistance (HOMA-IR) were also significantly higher in women with excessive weight gain during pregnancy as compared with group 2 (P=0.026 and P=0.045, respectively). Gestational age at delivery was similar in the two groups, while birthweight and the rate of macrosomia were significantly higher in group 1 than in group 2 (P=0.033 and P=0.014, respectively). Placental lesions consistent with fetal thrombo-occlusive disease were more prevalent in group 1 than in group 2. CONCLUSIONS: Excessive weight gain during pregnancy is associated with increased IMT of the carotid arteries that correlate with abnormal metabolic parameters, adverse pregnancy outcome and abnormal placental findings.