Low pregestational fat mass and subsequent maternal cardiovascular maladaptation in early pregnancy. The missing link for preeclampsia

Objective: Aim of the study is to identify patients at high risk of hypertensive complication during pregnancy throughout the assessment of pre-pregnancy maternal fat mass and TVR. Methods: 38 healthy, normotensive women were subjected to Bioimpedance during the antenatal visit and to haemodynamic measurement throughout the USCOM method during the antenatal visit and in the first trimester. Results: Patients were divided into two groups during the first trimester: Group A (n = 22) with TVR<1200 dynes.sec.cm-5, Group B (n = 16) with TVR>1200 dynes.sec.cm-5. There were no significant differences between the two groups in terms of maternal age, parity, gestational age and BMI. Cardiac output, stroke volume and TVR were statistically different between the two groups during the preconceptional visit and during the first trimester. Fat Mass (FM) was significantly greater in the low TVR group (p <0.05) while no statistically significant difference was found in the other bioimpendance parameters. Discussion: Our data showed the poor accuracy of BMI in expressing the maternal body composition compared with bioimpendance. Moreover, in the group with low TVR is possible to identify a subgroup with high fat mass that could be at higher risk of late preeclampsia difficultly recognizable throughout TVR and BMI. On the other side a too low fat mass might negatively influence maternal adaptation to pregnancy. Conclusion: Fat mass could be a better marker of body composition and a target to monitor the effectiveness of dietary changes improving maternal and neonatal outcome.