Women who were underweight
when they were born are at greater risk of severe pre-eclampsia
in pregnancy, a Swedish study involving 6,000 women
suggests.
The risk is particularly pronounced
if their mothers had pre-eclampsia when pregnant with
them, researchers say.
Pre-eclampsia is a common condition
which causes high blood pressure and can put the mother's
life at risk.
UK experts said doctors should use
the findings, reported in BJOG, to identify women who
need more careful monitoring.
The researchers looked at more than
6,000 women under the age of 30 years who had been unusually
small when they were born and who had given birth themselves.
Women who were underweight when born
had a "markedly increased" risk for severe pre-eclampsia
during their pregnancy, they said.
If their mothers had also had pre-eclampsia,
the risk was doubled.
The research supports previous work
suggesting that pre-eclampsia may run in families.
Low birth weight is also believed to
be related to other conditions associated with high
blood pressure, such as heart disease.
Prevention
Spotting pre-eclampsia early on can
be difficult, despite routine monitoring of blood pressure,
and knowing who might be more at risk would be useful.
Dr Karin Zetterstrom, study leader
and gynaecologist and obstetrician at Orebro University
Hospital in Sweden, said pre-eclampsia could be dangerous
to a mother and baby in many ways.
"Those who are born underweight also
have high risk of heart disease and the severe form
of pre-eclampsia might be part of that pathway.
"It might be of value to ask a woman
if she was born underweight or if her mother had pre-eclampsia
because we know she is at high risk that her pre-eclampsia
will turn out to be the severe form."
Professor Andrew Shennan, professor
of Obstetrics and Gynaecology at King's College London
and spokesperson for the baby charity Tommy's, agreed
with the researchers recommendations for identifying
and monitoring those at increased risk.
He said finding women at risk of the
severe form of the condition was key.
"One of the really important things
is distinguishing between early (commonly severe) and
late onset pre-eclampsia because early onset is where
the problems lie.
"But paradoxically we don't see people
very often at that crucial time and that's the time
we need increased surveillance."
"This is quite new stuff and a lot
of obstetricians may not even be thinking about it,"
he added.
Professor Phil Steer, BJOG editor-in-chief,
said: "What this research demonstrates is the need for
careful and detailed history taking when a woman is
first seen in pregnancy.
"If we know that the likelihood of
a woman developing severe pre-eclampsia is high, increased
surveillance during pregnancy and early appropriate
management will help to safeguard the health of both
mother and baby."