151. Aldosterone as independent predictor of placental and birth weights: Odense Child Cohort study

Abstract

Introduction Aldosterone is involved in plasma volume expansion and its levels, along with the levels of other members of the renin-angiotensin-aldosterone system (RAAS), are increased in healthy pregnancy. Aldosterone appears to contribute to an optimal fetal development by enhancing placental growth factor (PlGF) expression and trophoblast cell proliferation. In contrast to normal pregnancy, aldosterone is suppressed in preeclampsia. Hypothesis Aldosterone independently contributes to placental and fetal growth. Methods The project is based on data from the Odense Child Cohort, a prospective population-based study from the Municipality of Odense, Denmark, currently with 2500 active families. The participants were recruited between 2010 and 2012. To analyze plasma aldosterone levels and urinary aldosterone excretion (UAldoV), we used a subsample of 637 urine samples (24-h collections) from gestational week 28. Plasma aldosterone and UAldoV were determined by a commercially available ELISA. Predictive values of aldosterone were assessed by multiple regression analysis. Primary outcomes were placental weight (PW) and gestational age-adjusted birth weight Z-score (BW sds). Results UAldoV, but not plasma aldosterone concentration, independently contributed to PW and BW sds (adjusted β coefficients ± SEM: 3.21 ± 1.51, p Discussion At 28 weeks of gestation, 24-h urinary aldosterone excretion was an independent predictor of placental and birth weights. In perspective, aldosterone could be a candidate biomarker for future screening and monitoring programs of high-risk pregnancies. Our findings support the physiological role for aldosterone and likely NaCl conservation for normal pregnancy. Mineralocorticoid supplementation could be considered for pregnancies with high risk for IUGR in order to achieve elevated levels of mineralocorticoids and thus benefit placental and fetal development.