Adriëtte Oostvogels

2 43 pBMI, lipids and BP during pregnancy Independent effect of prepregnancy weight status on BP course during pregnancy No evidence was found for a difference in BP course between women with normal weight and overweight, except for an absolute overall difference, as adding the interaction terms between weight status and time period yielded no significant improvement in the model [p=0.98 (SBP) and p=0.30 (DBP)]. During pregnancy, women with overweight had on average a 4.3 mmHg higher SBP (95%CI:3.6-5.1) and a 3.3 mmHg higher DBP (95% CI:2.8-3.9). Adjustments for the covariates increased these differences to 5.3 (SBP; 95% CI:4.6-6.0) and 3.9 mmHg (DBP; 95% CI:3.3-4.5) (Figure 2; Tables 3 and 4). Thus, there was no significant difference between the two BP courses, except that women with overweight had a higher BP from the start (Figure 2). Mediation of early pregnancy lipid profile in the association between prepregnancy weight status and blood pressure course during pregnancy When early pregnancy lipids were added to the model, the difference in BP during pregnancy between women with normal weight and overweight changed only slightly (Tables 3 and 4). Therefore, mediation of maternal lipids in the association between prepregnancy weight status and BP course during pregnancy seems unlikely. Independent effect of early pregnancy lipid profile on BP course during pregnancy Tables 3 and 4 also show the associations between early pregnancy lipids and BP course during pregnancy. During the entire course of pregnancy, all women in the highest lipid tertile had a higher SBP and DBP compared to women in the lowest tertile. Adding interaction terms between lipids and time period did not improve the model for SBP; i.e. women in the different tertiles of the lipids did not show a steeper or less steep increase or decrease in SBP over time. In contrast, the model for DBP was improved when interaction terms between TG and time period (Figure 3), FFA and time period (Figure 4), or ApoA1 and time period (Figure 5) were added to the corresponding model, indicating that women in the different tertiles of these lipids had a different DBP course. For TG, women in the highest tertile had a smaller decrease in the first time period and a steeper increase in the third period than women in the lowest tertile of TG. Women in the highest tertile of ApoA1 had a steeper increase in the third period compared to women in the lowest tertile of ApoA1. Women in the middle tertile of FFA had a smaller increase in DBP in the second time period compared to the women in the lowest tertile of FFA.