Increased Risk of Preeclampsia in Women With a Genetic Predisposition to Elevated Blood Pressure

Abstract

Background: Preeclampsia causes significant maternal and perinatal morbidity. Genetic factors seem to affect the onset of the disease. We aimed to investigate whether the polygenic risk score for blood pressure (BP; BP-PRS) is associated with preeclampsia, its subtypes, and BP values during pregnancy. Methods: The analyses were performed in the FINNPEC study (Finnish Genetics of Pre-Eclampsia Consortium) cohort of 1514 preeclamptic and 983 control women. In a case-control setting, the data were divided into percentiles to compare women with high BP-PRS (HBP-PRS; >95th percentile) or low BP-PRS (≤5th percentile) to others. Furthermore, to evaluate the effect of BP-PRS on BP, we studied 3 cohorts: women with preeclampsia, hypertensive controls, and normotensive controls. Results: BP values were higher in women with HBP-PRS throughout the pregnancy. Preeclampsia was more common in women with HBP-PRS compared with others (71.8% and 60.1%, respectively; P =0.009), and women with low BP-PRS presented with preeclampsia less frequently than others (44.8% and 61.5%, respectively; P <0.001). HBP-PRS was associated with an increased risk for preeclampsia (odds ratio, 1.7 [95% CI, 1.1–2.5]). Furthermore, women with HBP-PRS presented with recurrent preeclampsia and preeclampsia with severe features more often. Conclusions: Our results suggest that HBP-PRS is associated with an increased risk of preeclampsia, recurrent preeclampsia, and preeclampsia with severe features. Furthermore, women with HBP-PRS present higher BP values during pregnancy. The results strengthen the evidence pointing toward the role of genetic variants associated with BP regulation in the etiology of preeclampsia, especially its more severe forms.

Associations of polygenic risk scores for preeclampsia and blood pressure with hypertensive disorders of pregnancy

“…In a recent smaller study of 1514 preeclamptic individuals and 983 controls, a BP-PRS above the 95th percentile was associated with 1.7-fold greater odds of preeclampsia and especially its more severe forms. However, this association was not statistically significant after adjustment for the first antenatal blood pressure measurement [ 9 ]. This risk increase is similar to that observed for a BP-PRS in the top 2.5 percentile in our study.…”

“…In addition, a polygenic risk score (PRS) for hypertension was associated with an increased risk of preeclampsia [ 8 ]. In a recent study by Kivioja et al [ 9 ], a high BP-PRS score was associated with preeclampsia and especially its more severe forms. However, the associations between genetic propensity for chronic hypertension and other hypertensive disorders of pregnancy disorders remain unknown.…”

Cross-Generational Impact of Innate Immune Memory Following Pregnancy Complications

“…It is also important to consider the impact of genetic factors and lifestyle choices on the development of pregnancy complications and the risk of subsequent disease. For example, the polygenic risk score for high blood pressure is associated with an increased risk of pre-eclampsia, as well as the development of hypertension [ 150 ]. These genetic risk factors may also be transmitted to the offspring, thereby predisposing them to future disease.…”

Optimization of the prevention of perinatal pathology in women with gestational endotheliopathy

“…В умовах низької народжуваності в Україні сприятливий результат кожної вагітності є найважливішим завданням. Один із головних напрямів у розв'язанні проблем охорони материнства та дитинства в Україні пов'язаний зі зменшенням кількості випадків перинатальної патології (ВПП), які розглядаються як кінцевий результат впливу соціальних, медичних і біологічних чинників на здоров'я вагітної, плода та новонародженої дитини [3,9,25,[27][28][29]. Впровадження в широку клінічну практику основних положень концепції гетерогенності ВПП має забезпечити обґрунтований диференційований підхід до ранньої доклінічної діагностики та стратифікації ризику патології вагітності й оптимальної профілактики [12,13,38].…”