Pre-eclampsia

Abstract

Pre-eclampsia is a life-threatening disease of pregnancy unique to humans and a leading cause of maternal and neonatal morbidity and mortality. Women who survive pre-eclampsia have reduced life expectancy, with increased risks of stroke, cardiovascular disease and diabetes, while babies from a pre-eclamptic pregnancy have increased risks of preterm birth, perinatal death and neurodevelopmental disability and cardiovascular and metabolic disease later in life. Preeclampsia is a complex multisystem disease, diagnosed by sudden-onset hypertension (>20 weeks of gestation) and at least one other associated complication, including proteinuria, maternal organ dysfunction or uteroplacental dysfunction. Pre-eclampsia is found only when a placenta is or was recently present and is classified as preterm (delivery <37 weeks of gestation), term (delivery ≥37 weeks of gestation) and postpartum pre-eclampsia. The maternal syndrome of pre-eclampsia is driven by a dysfunctional placenta, which releases factors into maternal blood causing systemic inflammation and widespread maternal endothelial dysfunction. Available treatments target maternal hypertension and seizures, but the only 'cure' for pre-eclampsia is delivery of the dysfunctional placenta and baby, often prematurely. Despite decades of research, the aetiology of pre-eclampsia, particularly of term and postpartum pre-eclampsia, remains poorly defined. Significant advances have been made in the prediction and prevention of preterm pre-eclampsia, which is predicted in early pregnancy through combined screening and is prevented with daily low-dose aspirin, starting before 16 weeks of gestation. By contrast, the prediction of term and postpartum pre-eclampsia is limited and there are no preventive treatments. Future research must investigate the pathogenesis of pre-eclampsia, in particular of term and postpartum pre-eclampsia, and evaluate new Nature Reviews Disease Primers | (2023) 9:8 2 0123456789();: Primer Epidemiology Incidence and mortalityThe global prevalence of all pre-eclampsia in the years 2002-2010 was estimated at 4.6% of deliveries but reported regional rates varied between 1% and 5.6% 14 . Where reported, the prevalence of preterm pre-eclampsia is <1% [15][16][17][18] . The prevalence of pre-eclampsia is generally reported as lower in low-income and middle-income countries (LMICs) (except sub-Saharan Africa) than in high-income countries (HICs) 19,20 ; however, it is likely that differences in classification, access to prenatal care and under-reporting in LMICs affect prevalence data 20,21 . Furthermore, most pre-eclampsia research is performed in HICs, potentially leading to bias and generalizability concerns in the populations sampled and the research questions asked.Hypertensive disorders of pregnancy (including pre-eclampsia) are the second most common cause (behind haemorrhage) of maternal Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rights...

Evaluation of Hypertensive Disorder of Pregnancy and High Refractive Error in Offspring During Childhood and Adolescence

“…This finding supported that HDP may damage the retina of progeny and affect refractive development in offspring through oxidative stress resulting in short- and long-term refractive errors . Third, individuals born to a preeclamptic pregnancy would have increased risk of preterm birth due to placental dysfunction and may therefore have a higher risk of subsequent RE …”

“… 5 , 34 Third, individuals born to a preeclamptic pregnancy would have increased risk of preterm birth due to placental dysfunction and may therefore have a higher risk of subsequent RE. 35 , 36 …”

“…of preterm birth due to placental dysfunction and may therefore have a higher risk of subsequent RE. 35,36 Empirical evidence is lacking for the association of maternal HDP with overall high RE and specific types in offspring in childhood and adolescence. The proportion of maternal hypertension was higher in children with congenital myopia (11 of 38 cases) than in the control group with other visual defects (2 of 39 cases) in a small case-control study.…”

Highly Flexible Deep-Learning-Based Automatic Analysis for Graphically Encoded Hydrogel Microparticles

“…These particles were conjugated with capture antibodies specific to each target protein for protein detection. The preeclampsia is a complex multisystem disease after pregnancy that may cause fetal growth restriction or an angiogenic imbalance . Moreover, multiplexing with these targets on the HMP-based platform has already been validated in previous research. − The multiplex bioassay procedure is illustrated in Figure S8 with detailed conditions.…”

Is there a link between antiretroviral therapy and hypertensive disorders of pregnancy?

“…Hypertensive disorders of pregnancy are an important issue because they can impact both pregnancy outcomes and maternal health [7]. HDP cover a wide spectrum of conditions.…”