Oral Presentation Society of Obstetric Medicine of Australia and New Zealand and Australasian Diabetes in Pregnancy Society Joint Scientific Meeting 2017

Maternal body composition, energy homeostasis and micronutrient intake 6 months after hypertensive compared to normotensive pregnancy (#32)

Sai Sankare Siritharan 1 , Amanda Henry 1 2 , Lynne M Roberts 2 3 , Amanda Yao 1 3 , Melissa Ojurovic 1 , Tony J O'Sullivan 3 4
  1. School of Women’s and Children’s Health, UNSW Medicine, Sydney, NSW, Australia
  2. Department of Women’s and Children’s Health, St George Hospital, Sydney, NSW, Australia
  3. St George and Sutherland Clinical School, UNSW Medicine, Sydney, NSW, Australia
  4. Department of Endocrinology, St George Hospital, Sydney, NSW, Australia

Introduction

After hypertensive pregnancy, women are at increased cardiovascular and cerebrovascular disease risk. Oxidative stress plays a key role in atherogenesis, and micronutrient antioxidant properties may be protective. Excess body fat (BF%) increases cardiovascular risk, however the relationship between BF% and micronutrient intake is unclear. This study aimed to compare body composition (BC), energy expenditure (EE) and energy intake (EI), including micronutrient intake, after hypertensive (HP) versus normotensive (NP) pregnancy.

 

Methods

A prospective sub-study of the P4 (Postpartum, Physiology, Psychology and Paediatrics) study. Women were studied 6 months after NP versus HP (preeclampsia or gestational hypertension). BC was measured using multi-frequency bio-impedance analysis, 24-hr EE using SenseWearTM Armbands, and EI using a three-day food diary and FoodWorksTM to calculate macronutrient and micronutrient intake.

 

Results

69 women (56 NP and 13 HP), mean age 32.2±4.4 and 31.2±5.3 years (p=0.47), and mean BMI 24.1±3.8kg/m2 and 29.1±8.3kg/m2 (p=0.05) respectively, had complete measurements. HP women had non-significantly higher BF% (39.4±8.6 versus 35.1±8.5%; p=0.10), non-significantly higher total EE (11106±2153 versus 10308±1654kJ; p=0.15), but significantly lower total EI (7833±1631 versus 9962±3159kJ; p=0.02) and EI/kilogram bodyweight (107±39 versus 159±55kJ/kg; p=0.002). HP women reported decreased intake of protein (p=0.03), total fat (p=0.02) and trans-fatty acids (p=0.02). Regarding micronutrients, the HP group reported lower vitamin E (p=0.04), vitamin B6 (p=0.03), vitamin B12 (p=0.05), vitamin A equivalents (p=0.03), retinol (p=0.02), alpha-tocopherol (p=0.02), and magnesium (p=0.005) intake. There were no significant differences in other macronutrient (carbohydrate, saturated fat, polyunsaturated fat, cholesterol) and micronutrient (thiamine, vitamin C, folic acid, beta-carotene, iron, calcium, zinc, selenium, iodine) intakes.

 

Conclusion

Six months postpartum, women with previous HP have significantly lower reported micronutrient intake compared to NP, potentially reflecting poorer diet quality. BC and energy homeostasis results suggest increased fat storage efficiency continues at least 6 months postpartum following HP, which may have adverse cardio-metabolic consequences.