Biological Rhythms and Preeclampsia

Abstract

The impact of impaired circadian rhythm on health has been widely studied in shift workers and trans-meridian travelers. A part from its correlation with sleep and mood disorders, biological rhythm impairment is a recognized risk factor for cardiovascular diseases and breast cancer. Preeclampsia is a major public health issue, associated with a significant maternal and fetal morbidity and mortality worldwide. While the risks factors for this condition such as obesity, diabetes, pre-existing hypertension have been identified, the underlying mechanism of this multi-factorial disease is yet not fully understood. The disruption of the light/dark cycle in pregnancy has been associated with adverse outcomes. Slightly increased risk for “small for gestational age” babies, “low birth weight” babies, and preterm deliveries has been reported in shift working women. Whether altered circadian cycle represents a risk factor for preeclampsia or preeclampsia is itself linked with an abnormal circadian cycle is less clear. There are only few reports available, showing conflicting results. In this review, we will discuss recent observations concerning circadian pattern of blood pressure in normotensive and hypertensive pregnancies. We explore the hypothesis that circadian misalignments may represent a risk factor for preeclampsia. Unraveling potential link between circadian clock gene and preeclampsia could offer a novel approach to our understanding of this multi-system disease specific to pregnancy.

Circadian clock-related genetic risk scores and risk of placental abruption

“…First, confirmation of our findings in independent dataset may serve to reinforce the role of sleep and rhythm disorders in the pathogenesis of PA and other reproductive disorders. Second, confirmation of our findings and the accumulation of findings from others [12, 25, 31–32] may motivate the development of behavioral and pharmacologic strategies to improve sleep and circadian organization of obstetric patients. Lastly, integration of genetic risk scores alone or in combination with other risk factors may improve clinical risk stratification and risk prediction efforts.…”

“…Circadian rhythms, known to be heritable [27–28], modulate human behavior, physiology and the timing of several neurological, medical and obstetric disorders including hemorrhagic and ischemic stroke [29], myocardial infarction [30], preeclampsia [31] preterm labor [15] and PA [17]. A conserved genetic network regulates circadian rhythms.…”

“…Of note, altered expression level of CRY2 gene is found in pregnancy complications including gestational diabetes mellitus [40]. Furthermore, based on the epidemiological literature documenting the co-occurrence of preeclampsia with PA, and evidence linking circadian misalignment with preeclampsia risk [31], we conducted exploratory analyses to determine the extent to which, if at all, the association of the wGRS with PA was modified by maternal preeclampsia status. Although we observed some evidence suggestive of possible effect modification the global test did not reach statistical significance; and may be attributable to insufficient statistical power.…”

Chronobiological Aspects of Sleep Disorders in Menopausal Women: The Role of Melatonin (Literature Review)

“…В настоящее время показано, что какие-либо изменения в работе циркадной системы повышают риск развития таких патологических состояний, как нарушения сна [46], аффективные расстройства [28], диабет [36], онкология [22], пре-эклампсия [16], ожирение [33], сердечно-сосудистые заболевания [39], репродуктивные нарушения [48].…”

Early- and late-onset preeclampsia and the DNA methylation of circadian clock and clock-controlled genes in placental and newborn tissues

“…Recent reports, studying women working night shifts (in services such as healthcare, military, protection and airway), show associations between disrupting the light-dark cycle during pregnancy and a higher risk of PTB, low birth weight, spontaneous abortion and subfertility (Knutsson, 2003;Mahoney, 2010;Waddell et al, 2012). So far, however, only a few data are available on associations between alterations of the circadian rhythm and PE (Ditisheim et al, 2013;Haelterman et al, 2007;Mozurkewich et al, 2000;Wergeland & Strand, 1997). In this regard of interest is the hormone melatonin, which is regulated by the circadian clock and synthesized by the placenta thereby protecting against excessive oxidative stress involved in the pathogenesis of PE (Chen et al, 2013;Hobson et al, 2013;Valenzuela et al, 2015).…”