Altered Intrahepatic Hematopoiesis in Neonates from Women with Pregnancy Induced Hypertension/Pre-Eclampsia

Abstract

Aim: To detect whether preeclampsia influences neonatal intrahepatic hematopoiesis, given that an activation of fetal neutrophils and monocytes during the course of this disorder occurs. Experimental design: We examined liver samples from 10 neonates of hypertensive/preeclamptic women at 27 to 28 weeks of gestation delivered by a cessarian section. All neonates were placed in incubators but they all died within 24 hours due to immaturity. The control group comprised 10 fetuses of the same gestational age, after voluntary abortion due to a neural defect. Specific antibodies against CD34, glycophorin C, hemoglobins A and F, myeloperoxidase, CD61, CD68, terminal desoxynucleotidyl transferase and the pax-5/B-cell specific activator protein, were used in each sample. Results: Neonates from hypertensive/preeclamptic women, in comparison with controls, showed: a statistically significant reduction of erythropoiesis by 25% (p=0.015); a statistically significant increase of granulopoiesis (p=0.019); a statistically significant increase in the expression of CD68 positive cells of the monocytic lineage (p=0.017); a statistically significant increase in the expression of CD34 progenitor/stem positive cells (p=0.021). No statistically significant differences were observed in both examined groups, concerning megakaryopoiesis and B lymphopoiesis. Conclusions: Preeclampsia of pregnancy has an impact on neonatal intrahepatic hematopoiesis by increasing granulopoiesis, reducing erythropoiesis and triggering endothelial and stem cell activation. We suggest that these findings reflect a state of persistent inflammation and a loss of red blood cell production possibly contributing to the neonatal morbidity related to this disorder.

The roles of free iron, heme, haemoglobin, and the scavenger proteins haemopexin and alpha‐1‐microglobulin in preeclampsia and fetal growth restriction

“…In PE, reports show that newborn babies have reduced hepatic erythropoiesis [96] and that UCB contains more nucleated immature erythrocytes [173]. We found indications of higher concentration of HbF in haemolysed venous cord blood coming from the placenta, compared to arterial cord blood leading to the placenta, in both normal and PE pregnancies [174], but the venous HbF was higher in PE, compared to normal.…”

“…Most erythrocytes produced at this stage contain fetal Hb (HbF; α 2 γ 2 ) [85]. There are few studies on the effect of PE on fetal hepatic hematopoiesis but all point to severely reduced hepatic erythropoiesis and even increased granulopoiesis [95,96].…”