{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T00:46:33Z","timestamp":1792025193414,"version":"4.4.0"},"reference-count":34,"publisher":"Springer Science and Business Media LLC","license":[{"start":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T00:00:00Z","timestamp":1791936000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T00:00:00Z","timestamp":1791936000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Hypertens Res"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Hypertensive disorders of pregnancy (HDP) is a major cause of maternal morbidity worldwide. Although a higher pre-pregnancy body mass index (BMI) increases HDP risk, how HDP cases are distributed across BMI levels in relatively lean populations remains poorly characterized. We evaluated the association between pre-pregnancy BMI and HDP, the distribution of HDP cases across BMI levels, and model-predicted HDP incidence under hypothetical BMI distributions.<\/jats:p>\n                  <jats:p>This large-scale multicenter, retrospective study used longitudinal records of singleton pregnancies from 12 obstetric facilities in Japan between 2009 and 2024. The BMI\u2013HDP association was modeled using parity-stratified spline logistic regression. Model-predicted HDP incidence under hypothetical BMI distributions was estimated using spline-based standardization with woman-level bootstrap resampling.<\/jats:p>\n                  <jats:p>Among 52,042 pregnancies, 2,592 (5.0%) developed HDP. Although nulliparous women had higher baseline risk than multiparous women, the BMI-associated risk gradient was similar across parity groups. Most pregnancies were within normal BMI ranges, and most HDP cases arose in women without overweight or obesity. A population-wide\u00a00.5\u2009kg\/m\u00b2 downward BMI shift yielded a 5.5% relative reduction in model-predicted HDP incidence, compared with 6.7% under a BMI cap of 25.0\u2009kg\/m\u00b2. A population-wide\u00a01.0\u2009kg\/m\u00b2 downward shift yielded a 10.2% relative reduction, compared with 12.1% under a BMI cap of 23.0\u2009kg\/m\u00b2.<\/jats:p>\n                  <jats:p>Pre-pregnancy BMI was associated with HDP risk across the BMI continuum, while many HDP cases occurred within moderate BMI ranges. Modest downward BMI shifts yielded model-predicted HDP incidence similar to selected BMI-capping scenarios. These findings provide quantitative benchmarks for population-wide and high-risk approaches to preconception weight management.<\/jats:p>","DOI":"10.1038\/s41440-026-02847-7","type":"journal-article","created":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T00:06:58Z","timestamp":1792022818000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Pre-pregnancy BMI and hypertensive disorders of pregnancy in Japan: population burden and simulated BMI reduction scenarios for preconception and interpregnancy care"],"prefix":"10.1038","author":[{"given":"Sho","family":"Tano","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sumire","family":"Fujito","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tatsuo","family":"Inamura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuya","family":"Fuma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seiko","family":"Matsuo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satoru","family":"Katsuki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masato","family":"Yoshihara","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mamoru","family":"Yamashita","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomomi","family":"Kotani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroaki","family":"Kajiyama","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takafumi","family":"Ushida","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,10,14]]},"reference":[{"key":"2847_CR1","doi-asserted-by":"publisher","first-page":"24","DOI":"10.1161\/HYPERTENSIONAHA.117.10803","volume":"72","author":"MA Brown","year":"2018","unstructured":"Brown MA, Magee LA, Kenny LC, Karumanchi SA, McCarthy FP, Saito S, et al. 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Data may be shared upon reasonable request to the corresponding author, subject to institutional approval.","order":2,"name":"Ethics","label":"Data statement","group":{"name":"EthicsHeading","label":"Compliance with ethical standards"}},{"value":"Ethical approval was granted prior to study start by the ethics board of Nagoya University Hospital (approval number: 2015\u20130415) on 4\n                      th\n                      March 2016, with amendments on 24\n                      th\n                      June 2021 (22550) and 5\n                      th\n                      September 2022 (26473).","order":3,"name":"Ethics","label":"Details of Ethics Approval","group":{"name":"EthicsHeading","label":"Compliance with ethical standards"}}]}}