Title: Vitamin D in the womb may be protective for babies born from pregnancies complicated by preeclampsia 

Article Title: Associations of Cord Blood Vitamin D and Preeclampsia With Offspring Blood Pressure in Childhood and Adolescence

Category: Long-term effects

Lay Summary: A baby born from a pregnancy complicated by preeclampsia has an increased chance of having higher blood pressure in childhood, adolescence, and adulthood when compared to those born from a pregnancy without preeclampsia. In this study, investigators asked if this relationship (a child’s blood pressure after maternal preeclampsia) may be changed by the amount of vitamin D the baby had in the womb (called “in utero vitamin D status” – measured by the vitamin D level in the baby’s cord blood at birth). To answer this question, investigators studied 754 mother-child pairs that are enrolled in the Boston Birth Cohort. Pairs signed up for the Cohort between 1998 and 2009 and return for study visits with their mothers for measurement of their blood pressure (and other assessments) between the ages of 3 and 18.  Among these 754 pairs, 10.5% of mothers had preeclampsia during their pregnancy. In their analysis, investigators found that offspring blood pressure in childhood and adolescence was higher if their mother had preeclampsia compared to those who did not. This finding supports many other research studies that have shown the same relationship. However, when they also looked at the vitamin D levels from that baby’s cord blood when they were born- researchers found that the higher the in utero vitamin D status of the baby at birth the less increased the child’s blood pressure was.  This study shows that a baby’s vitamin D in the womb may be protective from some of the long term cardiovascular effects of being exposed to preeclampsia while in the womb. The next steps for this research would be to conduct clinical trials to better understand the relationship between a baby’s vitamin D level while growing in the womb, a mother’s vitamin D level while pregnant, and vitamin D’s effect on baby’s cardiovascular system during development.

Link: https://pubmed.ncbi.nlm.nih.gov/33017029/

Title: Messages in a bottle: Using microparticles to predict preeclampsia

Article Title: Late first trimester circulating microparticle proteins predict the risk of preeclampsia < 35 weeks and suggest phenotypic differences among affected cases

Category: Prediction

Lay Summary: As technology evolves, so do researchers’ ability to use new tools and methods to make tests to predict preeclampsia. In this study, investigators used cutting edge technology - the measurement of microparticles – to predict preeclampsia. Microparticles are tiny particles floating in a person’s blood that pinch off of your cells- such as your blood vessel cells, your immune cells, and your placenta cells. Researchers can now collect the blood of a patient, pull these microparticles out of the blood, and investigate what they are holding inside. Investigators for this study asked if the microparticles floating in a pregnant woman’s blood in early pregnancy could tell researchers that she may go on to develop preeclampsia. To answer this question, the researchers analyzed the microparticles from the blood of 23 women when they were 12 weeks pregnant who went on to be diagnosed with preeclampsia. There was also a group of 50 women included who were similar but didn’t develop preeclampsia. The researchers were able to identify a specific “signature” in these microparticles from early pregnancy for the patients who went on to develop preeclampsia, that was different from the patient who did not. This is a cutting edge, brand new approach to predicting preeclampsia. The next steps for this work will be to repeat these findings in a larger study.

Link: https://pubmed.ncbi.nlm.nih.gov/33087742/

Title: Linking gene signatures from the blood and the placenta to better understand preeclampsia

Article Title: Early-pregnancy transcriptome signatures of preeclampsia: from peripheral blood to placenta

Category: Prediction

Lay Summary: Research has shown that there is a link between maternal asthma, high body mass index (BMI) and low vitamin D levels with increased risk of developing preeclampsia. Researchers in this study explored if there is a possible genetic relationship between these 4 conditions (asthma, high BMI, vitamin D, and preeclampsia) in gene “signatures” (or pattern) found in maternal blood and in the placenta. To answer this question, researchers studied pregnant women’s blood in early pregnancy (between 10 and 18 weeks gestation). In their results, researchers found signature gene patterns among 2 separate groups of women with and without the 4 conditions: asthma, high BMI, low vitamin D, and preeclampsia. Then, in a separate study of preeclampsia, this gene pattern was found in the placenta! This study shows that there could be biologic relationships for preeclampsia with these other conditions before preeclampsia even develops. In the future, these genetic patterns may be useful in early pregnancy to predict who will develop preeclampsia.  This information may also be helpful in developing preventive measures for preeclampsia.

Link: https://pubmed.ncbi.nlm.nih.gov/33046794/

Title: Eating for two with chronic high blood pressure: Weight gain in pregnancy and risk for preeclampsia

Article title:  Gestational weight gain and adverse pregnancy outcomes by pre-pregnancy BMI category in women with chronic hypertension: A cohort study

Category:  Risk

Lay Summary:  To improve the chance of having a healthy pregnancy, women are recommended to gain a specific amount of weight during pregnancy. There is a weight range recommended for each patient depending on her pre-pregnancy weight and height. It is important to research how too much, too little, or the recommended amount of weight gained in pregnancy can play a role in pregnancy outcomes for women and their babies. In this study, researchers asked how weight gain in women with pre-existing high blood pressure (before they became pregnant) might be linked to their risk for adverse pregnancy outcomes, like preeclampsia and preterm birth. Researchers used data from the medical records of 14,369 women with preexisting high blood pressure between 2005 and 2014 to answer this question. Data on weight gain during pregnancy and any pregnancy complications that developed were collected. For their results, researchers found different relationships between pregnancy weight gain and pregnancy outcomes depending on pre-pregnancy weight and height of patients. In patients who started pregnancy with a healthy weight or overweight, ‘high weight gain’ (meaning- gaining more weight than recommended) was linked to a 40-90% increased risk of preeclampsia. Among patients who started pregnancy with obesity, a ‘low weight gain’ (meaning- gaining less weight than recommended) was linked to a 27-54% lower risk of preeclampsia. The results of this study could suggest that women with obesity and high weight gain during pregnancy may benefit from close monitoring for preeclampsia. More research is needed to identify weight ranges that could be customized based on a woman’s pre-pregnancy weight and height and her weight gain during pregnancy for certain adverse pregnancy outcomes.

Link: https://pubmed.ncbi.nlm.nih.gov/33181475/

Title: Linking preeclampsia and later in life cardiovascular disease in survivors

Article Title:  Angiogenic Factors and Long-Term Cardiovascular Risk in Women That Developed Preeclampsia During Pregnancy

Category:  Long-term effects

Lay Summary: Research has reported that two molecules in maternal blood- sFlt-1 and PlGF- are changed during pregnancy in many women who are diagnosed with preeclampsia (compared to women without preeclampsia). We also know that women with a history of preeclampsia are at greater risk for cardiovascular disease in later life. In this study, researchers asked if the levels of these two molecules in the blood during a pregnancy complicated by preeclampsia may be related to early signs of cardiovascular disease after pregnancy. To answer this question, investigators enrolled 64 women (43 with a history of preeclampsia, and 21 without) in this study and measured their cardiovascular health about 12 years after their pregnancies. They found both their PlGF levels and sFlt-1 levels during their past pregnancy were linked to early measures of cardiovascular disease. This study links directly the degree of short-term preeclampsia “exposure” to the long-term “outcome” of early cardiovascular disease. In the future, these results may be useful for women who have a history of preeclampsia- showing that risk factors for cardiovascular disease may be starting as early as 12 years postpartum (meaning in their 30s and 40s) and should encourage survivors to work with their healthcare providers to monitor her early cardiovascular risk factors (like blood pressure and lipid levels).

Link:  https://pubmed.ncbi.nlm.nih.gov/33012203/

About Research Roundup

Each quarter, our team of researchers reviews the most current studies related to hypertensive disorders of pregnancy and selects those studies they feel will be of greatest interest to our community to summarize.

Special thanks to our volunteer research team, who under the leadership of Dr. Elizabeth Sutton, make Research Roundup possible: Alisse Hauspurg, MD Felicia LeMoine, MD Jenny Sones, PhD, DVM, and Robin Trupp, PhD, RN.