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Comparative Study
. 2013 Apr 25:13:389.
doi: 10.1186/1471-2458-13-389.

BMI mediates the association between low educational level and higher blood pressure during pregnancy in Japan

Seung Chik Jwa  1 , Takeo Fujiwara, Akira Hata, Naoko Arata, Haruhiko Sago, Yukihiro Ohya
Affiliations
Comparative Study

BMI mediates the association between low educational level and higher blood pressure during pregnancy in Japan

Seung Chik Jwa et al. BMC Public Health. .

Abstract

Background: Research investigating the association between socioeconomic status (SES) and blood pressure (BP) during pregnancy is limited and its underlying pathway is unknown. The aim of this study was to investigate the mediators of the association between educational level as an indicator of the SES and BP in early and mid-pregnancy among Japanese women.

Methods: Nine hundred and twenty-three pregnant women in whom BP was measured before 16 weeks and at 20 weeks of gestation were enrolled in this study. Maternal educational levels were categorized into three groups: high (university or higher), mid (junior college), and low (junior high school, high school, or vocational training school).

Results: The low educational group had higher systolic (low vs. high, difference = 2.39 mmHg, 95% confidence interval [CI]: 0.59 to 4.19) and diastolic BP levels (low vs. high, difference = 0.74 mmHg, 95% CI: -0.52 to 1.99) in early pregnancy. However, the same associations were not found after adjustment for pre-pregnancy body mass index (BMI). BP reduction was observed in mid-pregnancy in all three educational groups and there was no association between educational level and pregnancy-induced hypertension.

Conclusion: In Japanese women, the low educational group showed higher BP during pregnancy than the mid or high educational groups. Pre-pregnancy BMI mediates the association between educational level and BP.

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Figures

Figure 1
Figure 1
Mean systolic blood pressure in early, mid-pregnancy stratified by educational level. Mean blood pressure was significantly different from that in subgroup of women with low (*) and mid (**) educational level (P<0.05).
Figure 2
Figure 2
Mean diastolic blood pressure in early, mid-pregnancy stratified by educational level. Mean blood pressure was not significantly different from that in subgroup of women with low and mid educational level (P<0.05).
See this image and copyright information in PMC

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