Increasing maternal weight: a risk factor for preeclampsia/eclampsia but apparently not for HELLP syndrome.

BACKGROUND: Maternal obesity is a risk factor for severe preeclampsia. We sought to ascertain whether a similar relationship exists between maternal weight and HELLP syndrome (hemolysis, elevated liver enzymes, and low platelets) as an atypical form of severe preeclampsia.

METHODS: In this retrospective investigation, 434 patients with HELLP syndrome were assigned to one of four study groups according to maternal weight and were analyzed in relation to selected maternal and perinatal data reflective of disease severity.

RESULTS: We found no significant associations between maternal weight and parameters of HELLP syndrome severity, race, delivery mode, gestational age, or perinatal outcome. Significantly associated with increasing maternal weight were maternal age, parity, admission mean arterial pressure, peak peripartum systolic blood pressures, concurrent essential hypertension, and the interval between admission and delivery. Inversely associated were eclampsia and the interval between delivery and discharge.

CONCLUSIONS: Severity and complications attendant with HELLP syndrome appear unrelated to maternal weight. Paradoxically, eclampsia occurs most commonly in the lighter gravida with HELLP syndrome.