LONG-TERM EFFECTS

Adverse Pregnancy Outcomes and Long-term Maternal Kidney Disease: A Systematic Review and Meta-analysis

JAMA Network Open

Researchers sought to combine the available data to study how a history of an “adverse pregnancy outcome” (like preeclampsia, gestational diabetes, or preterm delivery) might increase a woman’s risk for kidney disease later in her life. This analysis grouped together data on over 5 million women across 23 different research studies. Results showed that a history of preeclampsia doubles a woman’s risk for kidney disease in later life. A history of gestational hypertension (which is diagnosed as high blood pressure in pregnancy but without protein in the patient’s urine and with healthy organ function) increased risk of kidney disease by nearly 50%. Read the full review and analysis here. 

LONG-TERM EFFECTS

Maternal Cardiovascular Disease 3 Decades After Preterm Birth: Longitudinal Cohort Study of Pregnancy Vascular Disorders

Hypertension

Delivering a baby preterm (before 37 weeks’ gestation) has been linked to having an increased risk of cardiovascular disease in later life, but researchers don’t yet know how or why this link occurs. In this study, researchers collected pregnancy history and long-term data about hospitalizations for cardiovascular reasons in 1.2 million women across Quebec from 1989-2017. The study found that women who delivered a baby preterm (no matter for what reason) had an increased risk (about 1.5 times higher risk) for being hospitalized for cardiovascular disease in later life. To try to understand which reasons for preterm birth played a role in this future disease risk, researchers looked at the reasons women delivered preterm. The study found that about 25% of the link between preterm birth and future cardiovascular hospitalization could be explained by the mothers having a “vascular disorder in pregnancy”, like preeclampsia. Read the full article here.

ETIOLOGY (CAUSE)

Differential DNA Methylation in Placenta Associated With Maternal Blood Pressure During Pregnancy

Hypertension

The genes we have were given to us by our parents. Though our genes stay the same throughout our lives, scientists have discovered ways our bodies can turn on or turn off the genes that we do have. This field of study is called epigenetics. One method our cells can use to turn on or off genes is called “methylation” – this is when the cell puts a “flag” on a specific location of its DNA that allows the gene to either be used or not used. In this study, researchers looked at the DNA inside placenta cells of 301 women and searched for patterns of “flagging” (methylation) and the mothers’ blood pressure during pregnancy. For the first time ever discovered, researchers showed new patterns linking increased blood pressure in pregnancy and increased methylation on cardiometabolic genes in the placenta. These gene-blood pressure relationships may provide clues for the future to better understand the beginning of cardiometabolic disease. Read the entire article here. 

DIAGNOSIS

Altered Level of Salivary Placental Growth Factor Is Associated With Preeclampsia

Placenta

Placental growth factor (PlGF) is a hormone that has been measured in women’s blood in pregnancy shown to be lower in women who have preeclampsia. The goal of this study was to determine if PlGF could be measured in a non-invasive way -- in a patient’s saliva rather than her blood.  This is a pilot study (meaning a small-scale test of procedures to be used on a larger scale later) that only enrolled 28 women total.  Researchers found that they were able to measure PlGF in the patients’ saliva. PlGF levels were lower in patients with preeclampsia compared to patients with a normotensive (normal blood pressure) pregnancy as you would expect from PlGF levels measured in blood. You can read the full article here.

Editor's Note: Although this is a small study with a long way to go before it has clinical application (and therefore would not normally make it to this "best of" list), it is important to us because of our call-to-action to develop biomarkers for preeclampsia. You can read more about that at www.preeclampsia.org/biomarkers. 

LONG-TERM EFFECTS

Association Between Preeclampsia and Attention Deficit Hyperactivity Disorder: A Population-Based and Sibling-Matched Cohort Study

Acta Psychiatrica Scandinavica

Some studies of children from complicated pregnancies have shown them to be at increased risk for psychological differences. In this study, researchers wanted to study if there is a link between preeclampsia and attention-deficit hyperactivity disorder (ADHD) in children. Researchers studied over 2 million children, 114,000 of whom had ADHD. Results showed that children with mothers who had preeclampsia while pregnant were at very slight increased risk of ADHD (15% increase). Children born from a preeclamptic pregnancy and born small for gestational age were at a more increased risk of ADHD (43% increase). Read the full article here.

ABOUT THE RESEARCH ROUNDUP TEAM

Article selections for the Research Roundup are currated by Dr. Elizabeth Sutton and a team of preeclampsia experts: Dr. Jenny Sones, Dr. Alisse Hauspurg, Dr. Robin Trupp, and Dr. Felicia LeMoine. Dr. Elizabeth Sutton is 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. 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, who was born at 35 weeks from preeclampsia with severe features in 2017. Her second child, Gregory, was born in 2019 at 40 weeks after a normotensive pregnancy.