Abstract P140: Short-chain Fatty Acids Levels Are Lower In Women With Preeclampsia

Abstract

Introduction: Preeclampsia (PE) is a pregnancy-associated hypertension disorder with high morbidity and mortality. Short-chain fatty acids (SCFAs)—molecules produced by gut microbes—have been associated with hypertension, yet their relation to PE remains uncertain. Objectives: To review existing human studies that have examined associations of the major SCFAs (acetate, propionate, and butyrate) in pregnancy with the development of PE. Methods: Two reviewers independently searched online databases (EMBASE, PubMed, Web of Science, and Cochrane Database of Systematic Reviews) in January 2021 using the following terms: “short-chain fatty acids”, “acetic acid”, “butyric acid”, “propionic acid”, and “preeclampsia”. The final set of included studies had to: report associations of SCFAs with PE, be peer-reviewed, be written in English, and be in humans. Results: We screened the abstracts of 723 studies; 19 underwent full-text screening and 7 (980 total participants, 186 with PE) were included in the final review. All studies used a case-control design, but measured SCFAs from a range of bio-specimens (e.g., serum, plasma, feces, amniotic fluid) collected at distinct time points in pregnancy. Four studies showed that acetate was significantly (P<0.05) lower in women with PE compared to healthy women; the other three studies also found acetate was lower in PE cases, albeit the association was non-significant. All three studies that investigated butyrate found it was lower in PE cases vs. controls. The same three studies also reported lower propionate among PE cases vs. controls, though only one of them was statistically significant. Results did not materially differ by bio-specimen or time-point in pregnancy. Conclusions: Current evidence, which derives only from case-control studies, indicates that lower SCFA levels in pregnancy (measured in amniotic fluid, blood, and feces) may be related to the development of PE. Large cohort studies are warranted to further investigate this association.