Third‐Trimester Maternal Serum Chemerin and Hypertension After Preeclampsia: A Prospective Cohort Study

Abstract

Background Limited data are available for postpartum hypertension prediction after preeclampsia. Methods and Results We examined the association between maternal serum chemerin levels in patients with preeclampsia and blood pressure (BP) levels after delivery in a prospective birth cohort of 15 041 singleton pregnant women. A total of 310 cases among 322 patients with preeclampsia (follow‐up rate, 96.3%) were followed up during a mean 2.8 years after delivery. Compared with matched uncomplicated controls (n=310), serum chemerin measured at ≈35 gestational weeks was significantly increased in preeclampsia (171.8±49.2 versus 140.2±53.5 ng/mL; P <0.01) and positively correlated with the occurrence of postpartum hypertension, defined as either BP ≥130/80 mm Hg (per 1‐SD increase: odds ratio [OR], 4.01 [95% CI, 2.77–5.81]) or as BP ≥140/90 mm Hg (per 1‐SD increase: OR, 1.70 [95% CI, 1.28–2.25]) in patients with preeclampsia. The addition of chemerin levels improved the predictive performance of the clinical variable‐derived prediction models for postpartum hypertension (for BP ≥130/80 mm Hg: area under the curve, 0.903 [95% CI, 0.869–0.937], Δ area under the curve, 0.070, P <0.001; for BP ≥140/90 mm Hg: area under the curve, 0.852 [95% CI, 0.803–0.902], Δ area under the curve, 0.030, P =0.002). The decision curve analysis revealed a net benefit of the chemerin‐based prediction model for postpartum BP ≥130/80 mm Hg. Conclusions This study provides the first evidence supporting the independent predictive role of third‐trimester maternal chemerin levels for postpartum hypertension after preeclampsia. Future study is warranted for external validation of this finding.

Adipokines in Pregnancy: A Systematic Review of Clinical Data

“…Several studies also reported a correlation of chemerin levels with the severity of PE [48,49,51]. A positive association between chemerin levels towards the end of pregnancy in PE patients and maternal hypertension after birth was also described by Chen et al, in a prospective cohort study [50].…”

“…With regard to PE, reports were much more uniform. Two case-control studies, two cohort studies, one cross-sectional study, as well as one systemic review found chemerin levels in maternal serum to be significantly elevated in patients with PE [47][48][49][50][51][52]. Stepan et al, demonstrated that chemerin levels are not only increased during preeclamptic pregnancies but also remain elevated 6 months post-partum [47].…”

Understanding the Role of Chemerin in the Pathophysiology of Pre-Eclampsia

“…The incidence of postpartum hypertension in patients with PE was 45%, whereas in the control group, it was 17.4%. Maternal third-trimester chemerin serum levels positively correlated with postpartum blood pressure, and the authors concluded that chemerin may serve as a marker for the early prediction of postpartum hypertension [ 134 ]. Together with the results of another study confirming elevated chemerin serum levels 6 months after delivery in former PE patients in comparison to healthy controls [ 73 ], it is possible that chemerin might be one of the factors linking PE and future cardiovascular risk, but it needs further research.…”

Excessive Pregestational Weight and Maternal Obstetric Complications: The Role of Adipokines

“…Since the circulating concentrations of chemerin are positively correlated with insulin resistance, BMI, and serum triglycerides, it has been suggested that chemerin may play an important role in metabolic diseases; however, this is not yet conclusive [150]. Women with GDM or PE have higher chemerin levels than healthy pregnant women [151][152][153].…”