Adriëtte Oostvogels

2 45 pBMI, lipids and BP during pregnancy Effect modification of early pregnancy lipid profile on the association between prepregnancy weight status and BP course during pregnancy Figs 3-7 show the BP course for women with normal weight and overweight stratified by lipid status. Although some differences can be seen in the associations between maternal prepregnancy weight status, early pregnancy lipid profile and BP course during pregnancy, adding the interaction terms between prepregnancy weight status, lipid status and time did not significantly improve the model. Thus, most maternal early pregnancy lipids did not modify the assocation between prepregnancy weight status and BP during pregnancy. However, in the SBP course the overall interaction with TG, and in the DBP course the overall interaction with FFA, were almost significant (p=0.053 and p=0.064, respectively). On further analysis, we found that women with overweight in the highest tertile of TG had no decrease in SBP in the first period and a smaller increase in the second period of pregnancy (p<0.05) compared with the other women. Moreover, in the third time period, women with overweight in the highest tertile of FFA had a steeper increase in DBP followed by a smaller increase in the last time period, compared with the other women. Sensitivity analyses All analyses were repeated stratified by no complications (gestational age at birth ≥37 weeks and no gestational hypertensive disorders; S2 File) vs complications in pregnancy (gestational age at birth <37 weeks and/or PIH/PE; S3 File). In the subsample with no complications, SBP and DBP pattern were similar to the total study population, but differences between groups were similar. Adding an interaction term between time period, prepregnancy BMI and lipids did not improve the model fit for DBP, but for DBP the model fitted better with the interaction term was added to the models with TG, ApoA and FFA. For these lipids, differences between lipids were stable during the first 30 weeks of pregnancy, but hereafter, differences between the lipid tertiles diminished. The analyses in the subgroup with complications showed similar results with again smaller differences between women with overweight compared to women with normal weight. However, no clear patterns with maternal lipids could be determined.