Body composition by dual-energy X-ray absorptiometry in women with previous pre-eclampsia or small-for-gestational-age offspring.

OBJECTIVE: To investigate differences in body composition and fat distribution between women with previous pre-eclampsia or small-for-gestational-age (SGA) offspring and those with uncomplicated pregnancies. DESIGN: Cohort study. SETTING: Population-based study in a genetically isolated population in the southwest of the Netherlands. POPULATION: Women after pregnancies complicated by pre-eclampsia (n=45), SGA offspring (n=53) and uncomplicated pregnancies (n=106). METHODS: Women were compared for body composition and fat distribution variables, assessed by dual-energy X-ray absorptiometry (DXA) and anthropometrics at a mean follow-up time of 10.8 (SD +/- 5.9) years after pregnancy. MAIN OUTCOME MEASURES: Total lean and fat mass, android fat mass, gynoid fat mass, android-to-gynoid fat ratio, waist and hip circumference, waist-to-hip ratio. RESULTS: Women with previous pre-eclampsia compared with controls had higher mean total fat mass index (11.5 +/- 0.6 versus 9.7 +/- 0.4 kg/m(2); P = 0.03), lean mass index (15.8 +/- 0.3 versus 14.5 +/- 0.2 kg/m(2); P =0.001) and body mass index ([BMI]; 28.4 +/- 0.8 versus 25.4 +/- 0.5 kg/m(2); P = 0.005). Their waist circumferences (90.7 +/- 2.0 versus 78.5 +/- 1.3 cm; P < 0.001) and waist-to-hip ratios (0.86 +/- 0.01 versus 0.77 +/- 0.01; P < 0.001) were also higher as well as android fat mass (2.8 +/- 0.2 versus 2.1 +/- 0.1 kg; P = 0.01) and android-to-gynoid fat ratios (0.45 +/- 0.02 versus 0.39 +/- 0.01; P = 0.02). Mean total fat, lean and BMI was not significantly different between women with previous SGA offspring and controls, yet waist-to-hip ratios (0.83 +/- 0.01; P < 0.001) were higher. The observed differences in waist and hip circumference, waist-to-hip ratio and gynoid fat mass could not be attributed to differences in BMI. CONCLUSION: Women with previous pre-eclampsia or SGA offspring pregnancies compared with those with uncomplicated pregnancies have a preferential fat accumulation in the abdominal over hip region, which may explain, at least partly, their increased cardiovascular risk.

STOX1 gene in pre-eclampsia and intrauterine growth restriction.

The STOX1 gene, identified as a candidate gene for pre-eclampsia in Dutch women, is placentally expressed and subject to imprinting with preferential transmission of the maternal allele. In our study, STOX1-Y153H frequencies were similar in 157 women with pre-eclampsia (65%) and in 157 controls (64%) from the general Dutch population. In an isolated Dutch population, a distortion could not be demonstrated in the transmission of STOX1-Y153H variation from heterozygous mothers to offspring in 50 and 56 families with pregnancies complicated by pre-eclampsia or intrauterine growth restriction, respectively. Our findings do not confirm previous suggestions that STOX1 plays a major role in Dutch women with pre-eclampsia.