COVID-19 Not Hypertension or Diabetes Increases the Risk of Preeclampsia among a High-Risk Population

Morris, Rachael; Moustafa, Ahmed S. Zaki; Kassahun‐Yimer, Wondwosen; Novotny, Sarah; Billsby, Brittney; Abbas, Amira; Wallace, Kedra

doi:10.3390/ijerph192416631

Cited by 4 publications

(2 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…We focus on the subcellular changes that occur in pregnant women with COVID-19 to try to elucidate how those disorders may be triggered by the infection with SARS-CoV-2. 1,2 During pregnancy, the risk of adverse obstetric and neonatal outcomes is heightened by various respiratory viral infections. The physiological and immunological changes inherent to a normal pregnancy can result in systemic effects that make pregnant individuals more susceptible to complications from respiratory infections.…”

Section: Introductionmentioning

confidence: 99%

Sars-Cov-2 Infection During Pregnancy and Risk of Preeclampsia: A Systematic Review

Tua Sihotang

2023

JARMHS

View full text Add to dashboard Cite

Background: The concurrence of pregnancy-related diseases (gestational hypertension, preeclampsia and eclampsia) with the COVID-19 virus is a clinical novelty, classified as a serious maternal risk. 1 2 A living systematic review with meta-analysis in pregnant and recently pregnant women reported severe COVID-19 infection in 9 the intensive care unit admission required in 4%; invasive ventilation used in 2 and extracorporeal membrane oxygenation administered in 0.2 The aim: This study aims to show about SARS-CoV-2 infection during pregnancy and risk of preeclampsia. Methods: By comparing itself to the standards set by the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) 2020, this study was able to show that it met all of the requirements. So, the experts were able to make sure that the study was as up-to-date as it was possible to be. For this search approach, publications that came out between 2013 and 2023 were taken into account. Several different online reference sources, like Pubmed and SagePub, were used to do this. It was decided not to take into account review pieces, works that had already been published, or works that were only half done. Result: In the PubMed database, the results of our search brought up 99 articles, whereas the results of our search on SagePub brought up 66 articles. The results of the search conducted for the last year of 2013 yielded a total 98 articles for PubMed and 36 articles for SagePub. The result from title screening, a total 2 articles for PubMed and 16 articles for SagePub. In the end, we compiled a total of 8 papers. We included five research that met the criteria. Conclusion: The characteristics of SARS-CoV-2-infected pregnant women and preeclamptic women seem to be more or less similar with regard to proteinuria, elevated liver enzymes, thrombocytopenia, and increased pro-inflammatory markers. Hence, diagnosis of preeclampsia could be quite difficult.

show abstract

Section: Introductionmentioning

confidence: 99%

Sars-Cov-2 Infection During Pregnancy and Risk of Preeclampsia: A Systematic Review

Tua Sihotang

2023

JARMHS

View full text Add to dashboard Cite

show abstract

“…Було встановлено тісний зв'язок між тяжкістю COVID-19 і частотою ПЕ (p= 0,009). Жінки, які перенесли помірно критичний COVID-19, мали більшу ймовірність розвитку ПЕ порівняно з тими, у яких перебіг хвороби був малосимптомний або легкий [2].…”

unclassified

COVID-19 infection and hypertension disorders during pregnancy

Pylypenko,

Medved

2023

RHW

View full text Add to dashboard Cite

The objective: to determine the impact of COVID-19, which occurred before or during pregnancy, on the frequency of development and features of the course of gestational hypertension and preeclampsia.Materials and methods. An observational retrospective study with parallel control one was conducted. The pregnancy course and its outcomes in 178 women during the period of the COVID-19 pandemic – from March 2020 to January 2022 – who were observed in the women’s consultation of a private medical center, were analyzed. It is important to note that the medical documentation was taken one after the other, without being specially selected according to any principle, that is, the analysis carried out had the character of continuous screening.Out of 178 pregnant women, 125 (70.2%) persons were sick with COVID-19, they were included in the main group; 53 (29.8%) women who were part of the comparison group did not get sick. The groups are comparable by age and body mass index. The age of the women was 19–51 years; in the main group – 30.5±4.9 years, in the comparison group – 30.9±5.6 years. Body mass index (kg/m2) at the beginning of pregnancy in women of the main group was 21.6±4.3; comparison group – 22.9±4.8. There were 104 (58.4%) primigravida, 74 (41.6%) – multigravida. 117 (65.7%) women were primipara, 61 (34.3%) – multipara.All pregnant women were performed with a standard examination in accordance with the Order No. 417 of the Ministry of Health of Ukraine dated 15.07.2011. Clinical and anamnestic risk factors for the development of preeclampsia were assessed in all women without exception, on the basis of which 3 women were assigned to the risk group. In addition, 158 (88.8%) pregnant women as part of the first combined screening had an additional examination to determine the risk of developing preeclampsia, as a result of which additional 23 women were included in the risk group. As a result, 26 (14.6%) pregnant women from 12 weeks of gestation were prescribed prophylaxis using acetylsalicylic acid.Results. In women who have had COVID-19, hypertensive disorders of pregnancy develop statistically significantly less often than in those who have not had the disease. After mildly symptomatic COVID-19 the risks of hypertensive disorders in pregnant women are statistically significantly reduced: gestational hypertension – RR=1.15, 95% CI: 1.0–1.3; preeclampsia – RR=1.1, 95% CI: 1.0–1.2, all hypertensive disorders – BP=1.3, 95% CI: 1.1–1.6.The groups did not differ among themselves in the prevalence of generally accepted risk factors. The frequency of hypertensive disorders depending on the vaccination was analyzed. The risk of gestational hypertension in vaccinees who did not suffer from COVID-19 is reduced by 1.4 times (RR=1.4, 95% CI: 1.0–1.9), the risk of all hypertensive disorders in pregnant women in this same group is reduced 2 times (RR=2.0, 95% CI: 1.2–3.5).The development of preeclampsia also probably depends on the vaccination status (χ2=4.0; p=0.04; φ=-0.17). In non-vaccinated persons it increases by 1.1 times (RR=1.1, 95%CI: 1.2–1.8). The risk of all hypertensive disorders is also higher in the group with a negative vaccine status (RR=1.3, 95%CI: 1.0–1.7) only at the level of significance p=0.06, that is, it appears as a certain tendency.Conclusions. Hypertensive disorders associated with pregnancy are less likely to develop in women who have experienced COVID-19 in the preconception period or during pregnancy. Vaccination against COVID-19 reduces the frequency of hypertensive disorders in pregnant women, regardless of the disease presence.Since immune mechanisms, along with placental-vascular mechanisms play a significant role in the pathogenesis of preeclampsia, let’s assume that the experienced coronavirus infection or vaccination against it disrupts certain links of immunity, which results in a decrease in the frequency of hypertensive disorders in pregnant women.

show abstract

Hypertension and Cognitive Dysfunction in a Pregnant Rat Model of PE; a Role for CD4+ T Cells

Deer,

Herrock,

Simmons

et al. 2024

American J Rep Immunol

View full text Add to dashboard Cite

ObjectivePreeclampsia (PE) is associated with hypertension (HTN) during pregnancy and activated CD4+ T cells, inflammatory cytokines, and autoantibodies to the angiotensin II type I receptor (AT1‐AA). Having had COVID‐19 (CV) during pregnancy is associated with an increased incidence of a PE‐like phenotype. Both PE and CV have long‐lasting neurological implications and studies show that nonpregnant COVID patients produce AT1‐AA. We have shown that CD4+ T cells from PE women cause a PE phenotype in nude athymic rats. In this study, we sought to examine the role of CD4+ T cells from PE with a CV History (Hx) to contribute to a PE phenotype and to determine the importance of CD4+ T cells in cognitive dysfunction during pregnancy.MethodsAt delivery, blood and placentas were collected, and one million placental CD4+ T cells from each PE and each normotensive patient, with (NT) or without (NP) a CV (Hx) during pregnancy, were isolated, purified, and injected i.p. into a gestational day (GD) 12 pregnant nude athymic rat (one patient/rat). At GD19, blood pressure (MAP) and circulating factors were assessed in recipient rats. Cognitive function and memory were assessed using Novel Object Recognition and Barnes Maze tests, respectively. Placental ACE‐2 activity and AT1‐AA were measured from COVID Hx patients. A one‐ or two‐way ANOVA with Bonferroni's multiple comparisons test was used for statistical analysis.ResultsBlood pressure was increased in patients with PE, with or without COVID, compared to NT patients. There were no significant changes in placental ACE activity in patients with COVID Hx with or without PE. AT1‐AA was elevated in PE patients and in both PE and NT COVID Hx compared to control NP. In pregnant recipient rats, MAP increased in CV Hx PE (113 ± 2, n = 8) compared to CV Hx NT (101 ± 5, n = 6). PE and PE CV Hx CD4+ T Cell recipient rats exhibited impaired memory and cognitive dysfunction (p < 0.05), compared to control groups. Recipient rats of PE CV Hx CD4+ T cells had elevated AT1‐AA compared to NT CV Hx recipients. Both COVID Hx groups and recipients of PE CD4+ T cells had elevated TNF alpha compared to NP.ConclusionOur findings indicate that pregnant patients with a Hx of COVID during pregnancy produce AT1‐AA, with or without PE. Recipients of CD4+ T cells from PE with or without a CV Hx during pregnancy cause HTN and elevated AT1‐AA. TNF‐α is elevated in PE and in CV Hx NT and PE recipients. Interestingly, recipients of T cells from PE patients with or without a Hx of CV had worse cognitive function during pregnancy, compared to recipient rats of NP CD4+ T cells. These data demonstrate the importance of CD4+ T cells in HTN and impaired neurological function during PE in the presence or absence of a prior COVID‐19 infection during pregnancy.

show abstract

COVID-19 Not Hypertension or Diabetes Increases the Risk of Preeclampsia among a High-Risk Population

Cited by 4 publications

References 18 publications

Sars-Cov-2 Infection During Pregnancy and Risk of Preeclampsia: A Systematic Review

Sars-Cov-2 Infection During Pregnancy and Risk of Preeclampsia: A Systematic Review

COVID-19 infection and hypertension disorders during pregnancy

Hypertension and Cognitive Dysfunction in a Pregnant Rat Model of PE; a Role for CD4+ T Cells

Contact Info

Product

Resources

About