Lack of "dip" in blood pressure in mid-pregnancy is linked to an increased risk for preeclampsia
BioMed Central Pregnancy & Childbirth
In an uncomplicated pregnancy, blood pressure is expected to decrease in the first half of pregnancy, bottom out about 18-20 weeks gestation, then slowly rise again until delivery. This study investigated whether a lack of dip in blood pressure during pregnancy could be linked to future preeclampsia. Researchers found women who had increases in blood pressure early pregnancy to mid pregnancy had an 80% increased risk for going on to develop preeclampsia (compared to women who showed this blood pressure “dip” and had a decrease in blood pressure from early to mid-pregnancy). Read the original article here.
A new test has been found to quicken the diagnosis of preeclampsia in real-world settings
This study added a new test (measuring the hormone placental growth factor in mom’s circulation) into the prenatal care of 1,035 pregnant women suspected of having preeclampsia in 11 hospitals in the United Kingdom. Researchers hoped that adding this test would improve the time it takes to diagnose preeclampsia. The study results show that including the measurement of placental growth factor in women with suspected preeclampsia shortened the time it took to diagnose preeclampsia, which lead to quicker treatment, and ultimately a decrease in severe maternal adverse outcomes. Fetal outcomes (including death, NICU admission, birth weight, Apgar score, and preterm birth) were not different whether placental growth factor was measured or not. Read the original article here.
Using magnetic beads to remove sFlt-1 and increase PlGF from the circulation
This is a cutting-edge experiment testing a new technique for treating preeclampsia in human blood (note: experiments not conducted in women yet). An imbalance of molecules in the circulation that help control blood vessel growth is a hallmark of preeclampsia- too much of the molecule sFlt-1 and not enough of the molecule PlGF. In this study researchers successfully designed magnetic beads to capture sFlt-1 (the molecule you need less of) and release more PlGF (the molecule you need more of) in samples of human blood. These beads could one day offer a future treatment for preeclampsia. Read the original article here.
Stroke is a major cause of maternal death associated with preeclampsia or eclampsia
Obstetrics & Gynecology
In this study, researchers hoped to better understand the characteristics of stroke in preeclampsia-related deaths and find opportunities to improve care from these cases. This study analyzed data from maternal deaths related to preeclampsia or eclampsia in California between 2002 and 2007 (54 total). Results showed that 61% of these deaths were due to stroke. In 96% of the cases, systolic blood pressure was over 160 mmHg and headache was the most common symptom reported (in 87% of cases) preceding stroke. In 21 of the 32 stroke cases (66%), there was a good-to-strong chance to alter the outcome because of delayed response to warning signs or ineffective treatments used. This small study shows that stroke is a major cause of maternal death associated with preeclampsia or eclampsia and in all but one case patients had severe elevation of systolic blood pressure. The authors conclude there are opportunities to improve care and prevent maternal deaths from preeclampsia. Read the original article here.
LONG TERM EFFECTS
Children of preeclamptic pregnancies have increased blood pressure as early as 4 years old
Journal of Pediatrics
Researchers conducted a meta-analysis (when data from several smaller studies are pooled to create one large study). Using data from 36 studies and 53,029 children total, researchers asked if risk factors for cardiovascular disease were different in children whose mothers had preeclampsia compared to children of the same age whose mothers had uncomplicated pregnancies. The results showed that children whose mothers had preeclampsia (meaning, the children who were exposed to preeclampsia while growing in utero) had an increase in blood pressure and a mild increase in body mass index compared to children of the same age from an uncomplicated pregnancy. Other cardiovascular risk factors including circulating lipids, blood sugar, insulin, or vascular function were not different. Read the original article here.
Editor’s note: Research over the past 30 years has revealed that the environment an individual is exposed to in their mother’s womb can affect children’s long-term health. Smaller studies have shown that children exposed to preeclampsia while in their mother’s womb are at increased risk for cardiovascular disease in later life. However, it is not yet clear what contributes to this increased risk. This study suggests that early increases in blood pressure and increased body mass index are contributors to developing cardiovascular disease later in life for these children.
About Dr. Elizabeth Sutton
Research Roundup Editor
Dr. Elizabeth Sutton is the Research Roundup Editor for the Preeclampsia Foundation, while serving full-time as the Scientific Research Director at Woman's Hospital in Baton Rouge, Louisiana. Dr. Sutton is a preeclampsia survivor and researcher with a PhD in Molecular and Developmental Biology from Louisiana State University. Her research efforts are focused on the short and long-term cardiovascular and metabolic consequences of preeclampsia in mothers and their children. Her work has been published in numerous scientific journals including Cell Metabolism, Obstetrics & Gynecology, Diabetes, and the American Journal of Physiology. Dr. Sutton is dedicating her life's work to the study of preeclampsia and the dissemination of health education to preeclampsia survivors to honor her resilient daughter, Willow (born at 35 weeks from preeclampsia with severe features in 2017).