Background: Excessive gestational weight gain (GWG) have been theorized to precede HELLP syndrome (HELLPs) among Caucasian women mostly of western populations. This theory has not been validated among women of Nigerian origin. Hence, the current study evaluated the relationship between excessive GWG and the incidence of HELLPs among Nigerian women. Methods: The retrospective study was conducted among 108 supervised nulliparous pregnant women who were diagnosed with complete HELLPs by term (37-42 gestational age) in the University of Port Harcourt Teaching Hospital from 2011-2020. The relevant data of eligible cases were extracted from case notes, nurses’ charts, laboratory, and other medical files using a pre-tested research template and analyzed using the Statistical Package for Social Sciences software version 25. Results: During the study, 108 eligible cases were identified. At booking, the majority of the HELLPs patients were found to be overweight (n=49; 45.4%). At diagnosis by term, the HELLPs patients had markedly higher mean weight compared to their mean booking weight (booking weight: 74.32 ± 7.13 vs. term weight: 105.74 ± 7.59; p<0.001). The majority of the HELLPs patients had GWG above the Institute of Medicine (IOM) recommendations (n=67; 62.1%; p<0.001) by term. The underweight, ideal weight, overweight, and the obese with GWG below the IOM recommendations were less likely [adjusted odd ratio (aOR)<1.0] to develop HELLPs while those with GWG above the IOM recommendations were more likely (aOR>1.0) to develop HELLPs. However, the lower chance of incident HELLPs among those with GWG below the IOM recommendations was attenuated with increasing BMI status while the more likelihood of incident HELLPs among those with GWG above the IOM recommendations becomes amplified with increasing BMI status. Conclusion: The present study findings indicate that excessive GWG seemed to precede incident HELLPs among at-risk women in Nigeria. However, further studies are recommended to verify the conclusions of this study.
| Published in | American Journal of Laboratory Medicine (Volume 6, Issue 6) |
| DOI | 10.11648/j.ajlm.20210606.14 |
| Page(s) | 101-106 |
| Creative Commons |
This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited. |
| Copyright |
Copyright © The Author(s), 2021. Published by Science Publishing Group |
Nigeria, HELLP, HELLP Syndrome, Gestational Weight Gain
| [1] | Jiang R, Wang T, Li B, He J. Clinical characteristics and pregnancy outcomes of atypical hemolysis, elevated liver enzymes, and low platelets syndrome: A case series. Medicine (Baltimore). 2020; 99 (18): e19798. doi: 10.1097/MD.0000000000019798. |
| [2] | Rao D, Chaudhari NK, Moore RM, Jim B. HELLP syndrome: a diagnostic conundrum with severe complications. BMJ Case Rep. 2016; 2016: bcr2016216802. doi: 10.1136/bcr-2016-216802. |
| [3] | Dusse LM, Alpoim PN, Silva JT, Rios DR, Brandão AH, Cabral AC. Revisiting HELLP syndrome. Clinica Chimica Acta. 2015; 451: 117-20. |
| [4] | Rimaitis K, Grauslyte L, Zavackiene A, Baliuliene V, Nadisauskiene R, Macas A. Diagnosis of HELLP syndrome: a 10-year survey in a perinatology centre. Int J Environ Res Public Health. 2019; 16 (1): 109. |
| [5] | Stojanovska V, Zenclussen AC. Innate and adaptive immune responses in HELLP syndrome. Frontiers immunol. 2020; 11: 667. doi: 10.3389/fimmu.2020.00667. |
| [6] | Wallace K, Harris S, Addison A, Bean C. HELLP syndrome: pathophysiology and current therapies. Curr pharm biotechnol. 2018; 19 (10): 816-26. |
| [7] | Masho SW, Urban P, Cha S, Ramus R. Body mass index, weight gain, and hypertensive disorders in pregnancy. Am J hypertens. 2016; 29 (6): 763-71. |
| [8] | Martin Jr JN. Milestones in the quest for best management of patients with HELLP syndrome (microangiopathic hemolytic anemia, hepatic dysfunction, thrombocytopenia). Int J Gynecol Obstet. 2013; 121 (3): 202-7. |
| [9] | Physical status: the use and interpretation of anthropometry. Report of a WHO Expert Committee. World Health Organ Tech Rep Ser. 1995; 854: 1-452. |
| [10] | Kominiarek MA, Peaceman AM. Gestational weight gain. Am J Obstet Gynecol. 2017; 217 (6): 642-651. doi: 10.1016/j.ajog.2017.05.040. |
| [11] | Truong YN, Yee LM, Caughey AB, Chen YW. Weight gain in pregnancy: does the Institute of Medicine have it right? Am J Obstet Gynecol 2015; 212: 362. e1-8. |
| [12] | Hutcheon JA, Stephansson O, Cnattingius S, Bodnar LM, Wikström AK, Johansson K. Pregnancy weight gain before diagnosis and risk of preeclampsia: a population-based cohort study in nulliparous women. Hypertension. 2018; 72 (2): 433-41. |
| [13] | Hooja N, Tulani K, Bhargava S, Mital P. Association of Complications in Hypertensive Disease of Pregnancy with Body Mass Index. J Basic Clin Appl Health Sci 2020; 3 (1): 32–34. |
| [14] | Martin Jr JN, May WL, Rinehart BK, Martin RW, Magann EF. Increasing maternal weight: a risk factor for preeclampsia/eclampsia but apparently not for HELLP syndrome. South Med J. 2000; 93 (7): 686-91. |
| [15] | Leeners B, Rath W, Kuse S, Irawan C, Imthurn B, Neumaier-Wagner P. BMI: new aspects of a classical risk factor for hypertensive disorders in pregnancy. Clin Sci (Lond). 2006; 111: 81–6. |
| [16] | Leeners B, Neumaier-Wagner PM, Kuse S, Mutze S, Rudnik-Schoneborn S, Zerres K, et al. Recurrence risks of hypertensive diseases in pregnancy after HELLP syndrome. J Perinat Med. 2011; 39: 673–8. |
| [17] | Malmstrom O, Morken NH. HELLP syndrome, risk factors in first and second pregnancy: a population based cohort study. Acta Obstet Gynecol Scand 2018; 97: 709–716. |
| [18] | Orabona R, Sciatti E, Vizzardi E, Bonadei I, Prefumo F, Valcamonico A, Metra M, Frusca T. Maternal endothelial function and vascular stiffness after HELLP syndrome: a case-control study. Ultrasound Obstet Gynecol. 2017; 50 (5): 596-602. doi: 10.1002/uog.17394. |
| [19] | Roberts JM, Bodnar LM, Patrick TE, Powers RW. The role of obesity in preeclampsia. Pregnancy Hypertens 2011; 1: 6–16. |
APA Style
Collins Amadi, Bright Amadi. (2021). Excessive Gestational Weight Gain Precedes Incident HELLP Syndrome Among Nigerian Women. American Journal of Laboratory Medicine, 6(6), 101-106. https://doi.org/10.11648/j.ajlm.20210606.14
ACS Style
Collins Amadi; Bright Amadi. Excessive Gestational Weight Gain Precedes Incident HELLP Syndrome Among Nigerian Women. Am. J. Lab. Med. 2021, 6(6), 101-106. doi: 10.11648/j.ajlm.20210606.14
AMA Style
Collins Amadi, Bright Amadi. Excessive Gestational Weight Gain Precedes Incident HELLP Syndrome Among Nigerian Women. Am J Lab Med. 2021;6(6):101-106. doi: 10.11648/j.ajlm.20210606.14
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Download@article{10.11648/j.ajlm.20210606.14,
author = {Collins Amadi and Bright Amadi},
title = {Excessive Gestational Weight Gain Precedes Incident HELLP Syndrome Among Nigerian Women},
journal = {American Journal of Laboratory Medicine},
volume = {6},
number = {6},
pages = {101-106},
doi = {10.11648/j.ajlm.20210606.14},
url = {https://doi.org/10.11648/j.ajlm.20210606.14},
eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajlm.20210606.14},
abstract = {Background: Excessive gestational weight gain (GWG) have been theorized to precede HELLP syndrome (HELLPs) among Caucasian women mostly of western populations. This theory has not been validated among women of Nigerian origin. Hence, the current study evaluated the relationship between excessive GWG and the incidence of HELLPs among Nigerian women. Methods: The retrospective study was conducted among 108 supervised nulliparous pregnant women who were diagnosed with complete HELLPs by term (37-42 gestational age) in the University of Port Harcourt Teaching Hospital from 2011-2020. The relevant data of eligible cases were extracted from case notes, nurses’ charts, laboratory, and other medical files using a pre-tested research template and analyzed using the Statistical Package for Social Sciences software version 25. Results: During the study, 108 eligible cases were identified. At booking, the majority of the HELLPs patients were found to be overweight (n=49; 45.4%). At diagnosis by term, the HELLPs patients had markedly higher mean weight compared to their mean booking weight (booking weight: 74.32 ± 7.13 vs. term weight: 105.74 ± 7.59; p1.0) to develop HELLPs. However, the lower chance of incident HELLPs among those with GWG below the IOM recommendations was attenuated with increasing BMI status while the more likelihood of incident HELLPs among those with GWG above the IOM recommendations becomes amplified with increasing BMI status. Conclusion: The present study findings indicate that excessive GWG seemed to precede incident HELLPs among at-risk women in Nigeria. However, further studies are recommended to verify the conclusions of this study.},
year = {2021}
}
TY - JOUR T1 - Excessive Gestational Weight Gain Precedes Incident HELLP Syndrome Among Nigerian Women AU - Collins Amadi AU - Bright Amadi Y1 - 2021/12/09 PY - 2021 N1 - https://doi.org/10.11648/j.ajlm.20210606.14 DO - 10.11648/j.ajlm.20210606.14 T2 - American Journal of Laboratory Medicine JF - American Journal of Laboratory Medicine JO - American Journal of Laboratory Medicine SP - 101 EP - 106 PB - Science Publishing Group SN - 2575-386X UR - https://doi.org/10.11648/j.ajlm.20210606.14 AB - Background: Excessive gestational weight gain (GWG) have been theorized to precede HELLP syndrome (HELLPs) among Caucasian women mostly of western populations. This theory has not been validated among women of Nigerian origin. Hence, the current study evaluated the relationship between excessive GWG and the incidence of HELLPs among Nigerian women. Methods: The retrospective study was conducted among 108 supervised nulliparous pregnant women who were diagnosed with complete HELLPs by term (37-42 gestational age) in the University of Port Harcourt Teaching Hospital from 2011-2020. The relevant data of eligible cases were extracted from case notes, nurses’ charts, laboratory, and other medical files using a pre-tested research template and analyzed using the Statistical Package for Social Sciences software version 25. Results: During the study, 108 eligible cases were identified. At booking, the majority of the HELLPs patients were found to be overweight (n=49; 45.4%). At diagnosis by term, the HELLPs patients had markedly higher mean weight compared to their mean booking weight (booking weight: 74.32 ± 7.13 vs. term weight: 105.74 ± 7.59; p1.0) to develop HELLPs. However, the lower chance of incident HELLPs among those with GWG below the IOM recommendations was attenuated with increasing BMI status while the more likelihood of incident HELLPs among those with GWG above the IOM recommendations becomes amplified with increasing BMI status. Conclusion: The present study findings indicate that excessive GWG seemed to precede incident HELLPs among at-risk women in Nigeria. However, further studies are recommended to verify the conclusions of this study. VL - 6 IS - 6 ER -
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