Preeclampsia biomarkers: An assessment of maternal cardiometabolic health

Eastabrook, Genevieve; Aksoy, Tuba; Bedell, Samantha; Penava, Debbie; Vrijer, Barbra de

doi:10.1016/j.preghy.2018.06.005

Cited by 20 publications

(10 citation statements)

References 177 publications

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“…21 This may be correlated with prepregnancy subclinical vascular dysfunction and an increase in circulating antiangiogenic factors such as soluble vascular endothelial growth factor receptor-1 (sFlt-1) during the first trimester. 21,22 Our study further confirmed that primipara and high prepregnancy BMI were associated with the risk of HDP, which was consistent with previous studies. 2,4,23 However, our study failed to verify the correlation between ART and the risk of HDP.…”

Section: Discussionsupporting

confidence: 92%

The relationship between high–normal blood pressure in the first half of pregnancy and the risk of hypertensive disease of pregnancy

Zou

Yang

Cai³

et al. 2022

J of Clinical Hypertension

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Early warning of hypertensive disorder in pregnancy (HDP) can improve maternal and infant outcomes. However, few studies had evaluated the warning value of highnormal blood pressure (BP) before the onset of HDP. This was a prospective cohort study to investigate the relationship between high-normal BP in the first half of pregnancy and the risk of HDP. According to the maximum BP measured before 20 +6 weeks of gestation, the cohort was divided into three groups: optimal BP (SBP < 120 mmHg and DBP < 80 mmHg), normal BP (120 mmHg ≤ SBP < 130 mmHg or 80 mmHg ≤ DBP < 85 mmHg), and high-normal BP (130 mmHg ≤ SBP < 140 mmHg or 85 mmHg ≤ DBP < 90 mmHg). The relationship between different BP levels in the first half of pregnancy and HDP risk was assessed by general linear models. Ten thousand one hundred and ninety-three normotensive pregnant women with complete information were finally included for data analysis. Among them, 532 pregnant women were diagnosed with HDP, with a total HDP incidence of 5.2%. The incidences in the optimal, normal, and high-normal BP groups were 2.4%, 6.0%, and 21.8%, respectively. Compared to women with optimal BP in the first half of pregnancy, women with high-normal BP had a 445% increased risk of HDP (aRR: 5.45, 95% CI: 4.24-7.00), and even women with normal BP had a 107% increased risk of HDP (aRR: 2.07, 95% CI: 1.68-2.56). This study demonstrated that among low-risk healthy women, women with high-normal BP in the first half of pregnancy had a significantly higher risk of HDP.

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Section: Discussionsupporting

confidence: 92%

The relationship between high–normal blood pressure in the first half of pregnancy and the risk of hypertensive disease of pregnancy

Zou

Yang

Cai³

et al. 2022

J of Clinical Hypertension

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“…We also reinforced previous evidence that obesity predisposes to the occurrence of preeclampsia, especially in late-onset cases. This is probably associated with the inflammatory property of adipose tissue and its effects on endothelial function 31 . Considering that both BMI and weight gain rate are modifiable risk factors, consolidated knowledge of their predictive function emphasises the importance of antenatal counselling and prenatal care follow-up 32,33 .…”

Section: Discussionmentioning

confidence: 99%

Incidence and risk factors for Preeclampsia in a cohort of healthy nulliparous pregnant women: a nested case-control study

Mayrink

Souza

Feitosa

et al. 2019

Sci Rep

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The objective of this study is to determine the incidence, socio-demographic and clinical risk factors for preeclampsia and associated maternal and perinatal adverse outcomes. This is a nested case-control derived from the multicentre cohort study Preterm SAMBA, in five different centres in Brazil, with nulliparous healthy pregnant women. Clinical data were prospectively collected, and risk factors were assessed comparatively between PE cases and controls using risk ratio (RR) (95% CI) plus multivariate analysis. Complete data were available for 1,165 participants. The incidence of preeclampsia was 7.5%. Body mass index determined at the first medical visit and diastolic blood pressure over 75 mmHg at 20 weeks of gestation were independently associated with the occurrence of preeclampsia. Women with preeclampsia sustained a higher incidence of adverse maternal outcomes, including C-section (3.5 fold), preterm birth below 34 weeks of gestation (3.9 fold) and hospital stay longer than 5 days (5.8 fold) than controls. They also had worse perinatal outcomes, including lower birthweight (a mean 379 g lower), small for gestational age babies (RR 2.45 [1.52–3.95]), 5-minute Apgar score less than 7 (RR 2.11 [1.03–4.29]), NICU admission (RR 3.34 [1.61–6.9]) and Neonatal Near Miss (3.65 [1.78–7.49]). Weight gain rate per week, obesity and diastolic blood pressure equal to or higher than 75 mmHg at 20 weeks of gestation were shown to be associated with preeclampsia. Preeclampsia also led to a higher number of C-sections and prolonged hospital admission, in addition to worse neonatal outcomes.

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“…Notably, our study population had no signs of cardiometabolic health abnormalities, regardless of their BMI. It is becoming increasingly evident that BMI alone is not an accurate measure of an individual's cardiometabolic health, and thus, the obese women in our study are still within the window of metabolically healthy obesity, 23 while dysfunctional hyperactivation of autophagy may be seen in individuals with pathologies indicative of poor metabolic health.…”

Section: Discussionmentioning

confidence: 88%

Maternal obesity reduces placental autophagy marker expression in uncomplicated pregnancies

Cohen

Guo

Pucchio

et al. 2020

J of Obstet and Gynaecol

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Aim Obesity has been associated with changes in autophagy and its increasing prevalence among pregnant women is implicated in higher rates of placental‐mediated complications of pregnancy such as pre‐eclampsia and intrauterine growth restriction. Autophagy is involved in normal placentation, thus changes in autophagy may lead to impaired placental function and development. The aim of this study was to investigate the connection between obesity and autophagy in the placenta in otherwise uncomplicated pregnancies. Methods Immunohistochemistry and western blot analysis were done on placental and omental samples from obese (body mass index [BMI] ≥30 kg/m2) and normal weight (BMI <25 kg/m2) pregnant women with singleton pregnancies undergoing planned Caesarean delivery without labor at term. Samples were analyzed for autophagic markers LC3B and p62 in the peripheral, middle and central regions of the placenta and in omental adipocytes, milky spots and vasculature. Results As pre‐pregnancy BMI increased, there was an increase in both placental and fetal weight as well as decreased levels of LC3B in the central region of the placenta (P = 0.0046). Within the obese patient group, LC3B levels were significantly decreased in the placentas of male fetuses compared to females (P < 0.0001). Adipocytes, compared to milky spots and vasculature, had lower levels of p62 (P = 0.0127) and LC3B (P = 0.003) in obese omenta and lower levels of LC3B in control omenta (P = 0.0071). Conclusion Obesity leads to reduced placental autophagy in uncomplicated pregnancies; thus, changes in autophagy may be involved in the underlying mechanisms of obesity‐related placental diseases of pregnancy.

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Preeclampsia biomarkers: An assessment of maternal cardiometabolic health

Cited by 20 publications

References 177 publications

The relationship between high–normal blood pressure in the first half of pregnancy and the risk of hypertensive disease of pregnancy

The relationship between high–normal blood pressure in the first half of pregnancy and the risk of hypertensive disease of pregnancy

Incidence and risk factors for Preeclampsia in a cohort of healthy nulliparous pregnant women: a nested case-control study

Maternal obesity reduces placental autophagy marker expression in uncomplicated pregnancies

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