Cases Of Preeclampsia Research Articles

Short-Chain Fatty Acids and Preeclampsia: A Scoping Review.

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. The aim was to review existing human studies that examined associations of the major SCFAs (acetate, propionate, butyrate) in pregnancy with PE development. Two reviewers independently searched online databases (EMBASE, PubMed, Web of Science, and Cochrane Database of Systematic Reviews) in January 2024 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 conducted in humans. The abstracts of 907 studies were screened; 43 underwent full-text screening and 11 (1318 total participants, 352 with PE) were included in the final review. All studies used a case-control design. SCFAs were measured in a range of biospecimens (eg, serum, plasma, feces, placentas, and amniotic fluid) that were collected at distinct time points in pregnancy. All 7 studies that investigated butyrate found that it was lower in PE cases than in controls, with 6 of these showing statistical significance (P < .05). Five studies showed that acetate was significantly lower in individuals with PE compared with healthy individuals, while 1 study found that acetate was significantly higher in PE cases. One study reported significantly higher propionate among PE cases vs controls, while 2 studies reported significantly lower propionate levels in PE cases. The nuance in results for acetate and propionate may owe to reasons such as differences in distributions of population characteristics associated with SCFA level and PE or type of PE (early vs late). Current epidemiologic evidence, which derives only from case-control studies, suggests that SCFAs, particularly butyrate (protective), in pregnancy are related to the development of PE. Large-cohort studies are warranted to investigate the temporality and potential causality of these associations.

Aβ1-42 stimulates an increase in autophagic activity through tunicamycin-induced endoplasmic reticulum stress in HTR-8/SVneo cells and late-onset pre-eclampsia.

Environmental changes can trigger endoplasmic reticulum (ER) stress and misfolded protein accumulation, potentially leading to pre-eclampsia (PE). Amyloid-β (Aβ) is a crucial misfolded protein that can overactivate autophagy. Our study assessed the expression of Aβ1-42 and autophagic activity in PE placental tissues and trophoblasts under ER stress. Placental tissues were surgically collected from normal pregnant women (NP) and pregnant women with late-onset PE (LOPE) delivering through cesarean section. The expression levels of Aβ1-42 were detected in both PE and NP placental tissues, as well as in tunicamycin (TM)-induced HTR-8/SVneo cells. Autophagy-related proteins, such as Beclin-1, the ratio of LC3-II to LC3-I, ATG5, and SQSTM1/p62 in the placental tissues and HTR-8/SVneo cells were measured by Western blot. The number and morphology of autophagosomes were observed using transmission electron microscopy (TEM). Potential targets associated with the unfolded protein response (UPR) in the placental tissues of NP and PE cases were screened using PCR Arrays. The misfolded protein was significantly upregulated in the PE group. In both PE placental tissues and TM-induced HTR-8/SVneo cells, not only was Aβ1-42 upregulated, but also Beclin-1, ATG5, and LC3BII/I were significantly increased, accompanied by an increase in autophagosome count, while SQSTM1/P62 was downregulated. A total of 17 differentially expressed genes (DEGs) associated with the UPR were identified, among which elevated calnexin (CANX) was validated in the placenta from both PE and TM-induced HTR-8/SVneo cells. Autophagy is significantly upregulated in PE cases due to ER stress-induced Aβ1-42 accumulation, likely mediated by autophagy-related proteins involved in the UPR.

Left Atrial Mechanics Following Preeclamptic Pregnancy.

Preterm preeclampsia is a pregnancy complication associated with myocardial dysfunction and premature cardiovascular disease morbidity and mortality. Left atrial (LA) strain is a noninvasive index of left ventricular end diastolic pressure and an early marker of heart failure risk. This study aimed to evaluate LA strain during the postpartum period in participants with and without preterm preeclampsia and to assess whether this varied in the presence of hypertension, cardiac dysfunction or both. In this longitudinal cohort study, 321 women from 28 hospitals with preterm preeclampsia (cases) underwent cardiovascular assessment 6 months postpartum. This is a secondary analysis of the PHOEBE study (ISRCTN01879376). An uncomplicated pregnancy control group (n=30) was recruited from a single center for comparison. A full cross-sectional transthoracic echocardiogram was performed, and from these images, the myocardial strain of the left atrium, including reservoir, conduit, and contractile strain, as well as LA stiffness, were calculated. At 6 months postpartum, compared with controls, prior preeclampsia was associated with a significantly attenuated LA reservoir, conduit, and contractile strain, as well as increased LA stiffness (all P<0.001). LA strain was further reduced in preeclamptic women who had and had not developed hypertension, systolic, or diastolic dysfunction at 6 months postpartum (all P<0.05). LA mechanics were significantly attenuated at 6 months postpartum in participants with preterm preeclampsia, whether or not they remained hypertensive or had evidence of ventricular dysfunction. Further studies are needed to determine whether postnatal LA strain may identify women at greater risk for future cardiovascular disease.

ACME: A Classification Model for Explaining the Risk of Preeclampsia Based on Bayesian Network Classifiers and a Non-Redundant Feature Selection Approach

While preeclampsia is the leading cause of maternal death in Guayas province (Ecuador), its causes have not yet been studied in depth. The objective of this research is to build a Bayesian network classifier to diagnose cases of preeclampsia while facilitating the understanding of the causes that generate this disease. Data for the years 2017 through 2023 were gathered retrospectively from medical histories of patients treated at “IESS Los Ceibos” hospital in Guayaquil, Ecuador. Naïve Bayes (NB), The Chow–Liu Tree-Augmented Naïve Bayes (TANcl), and Semi Naïve Bayes (FSSJ) algorithms have been considered for building explainable classification models. A proposed Non-Redundant Feature Selection approach (NoReFS) is proposed to perform the feature selection task. The model trained with the TANcl and NoReFS was the best of them, with an accuracy close to 90%. According to the best model, patients whose age is above 35 years, have a severe vaginal infection, live in a rural area, use tobacco, have a family history of diabetes, and have had a personal history of hypertension are those with a high risk of developing preeclampsia.

A COMPARISON BETWEEN THE TWO METHODS OF MAGNESIUM SULFATE ADMINISTRATION FOR DURATION OF 12 VERSUS 24 H AFTER DELIVERY IN PATIENTS WITH SEVERE PREECLAMPSIA

Objective: Preeclampsia is one of the very serious and important complications of pregnancy which may culminate in serious maternal mortality and morbidity. For preventing eclampsia and convulsions, magnesium sulfate (Mg So4) is the medication of choice. As a standard method, it will be continued up to 24 hours after delivery of the baby. Shortening the duration of its administration can reduce the duration of hospital stay, risk of magnesium sulfate (Mg sulfate) toxicity and adverse effects, cost, duration of treatment, and patient satisfaction. The purpose of the present study was to compare the 2 methods of magnesium sulfate administration for a duration of 12 VS 24 hours after delivery in patients with severe preeclampsia. Design and method: The study was performed as a randomized clinical trial on 182 cases of severe preeclampsia. They were randomly assigned into the 2 groups. In one group, Mg sulfate was prescribed for 12 hours after delivery and in the other group, it was prescribed for 24 hours after delivery. The dosage of Mg sulfate was similar in both groups and only the duration of administration was different. Both groups were compared for the occurrence of convulsions and other adverse effects. Results: The women of the 2 groups did not have significant differences according to age, BMI, Parity, gravidity, or gestational age at the time of delivery. Also, systolic blood pressure, diastolic blood pressure, antihypertensive use, previous diabetes and renal disorders, gestational diabetes, and proteinuria were similar in both groups before treatment. One woman had a convulsion in the 12 hours group and Mg SO4 was continued for 24 hours in this case. Blood pressure, urine volume, and laboratory indexes did not show significant differences between the 2 groups before and after treatment. Also, adverse effects were similar in both groups. Pain at the injection site was less in the 12-hour group (P=0.048). Conclusions: Administration of Mg sulfate for 12 hours after delivery should be considered somehow as effective as 24 24-hour prescription for preventing convulsion after delivery.

Comparison of choroidal thickness in healthy pregnant and preeclamptic women in a tertiary eye care center in Central India: A cross-sectional study

Aim: To compare the Subfoveal Choroidal Thickness (SFCT) measured by Enhanced Depth Imaging (EDI) technique of Spectral Domain Optical Coherence Tomography (SD-OCT) in healthy pregnant and preeclamptic women. Methods: Our study was cross-sectional hospital-based study in which healthy pregnant women and women having preeclampsia were selected from Obstetrics and Gynecology department and enrolled in it. The guidelines of the American College of Obstetricians and Gynecologists were used to diagnose the cases of preeclampsia. The study included 100 women (200 eyes) which were grouped into 50 healthy pregnant women (group 1), i.e., n = 100 eyes and 50 preeclamptic women (group 2), i.e., n = 100 eyes. SFCT was measured using the EDI technique of SD-OCT and data were entered in a Microsoft Excel sheet. Statistical analysis was done using Epi Info. Software version 7.2.1.0 (Atlanta, Georgia, US) and the results of both the groups were compared. Results: The mean SFCT in both the eyes of the healthy pregnant group and the preeclamptic group was 318.12 ± 37.12 µm and 209.04 ± 26.73 µm, respectively, with a P-value 0.001 showing a statistically significant difference between both the groups. Conclusion: The SFCT is significantly decreased in preeclamptic pregnant women than in healthy pregnant women.

An Observational Study of Maternal and Perinatal Outcome in Preeclampsia Cases in a Tertiary Care Center.

Preeclampsia, a hypertensive disorder in pregnancy, is a multisystem disease of unknown etiology and is associated with an increased risk of maternal mortality and morbidity.Infants from preeclampsia mothers have significantly higher incidence of prematurity, somatic growth retardation, thrombocytopenia, low birth weight, respiratory distress syndrome, and long duration of admission to neonatal intensive care (NICU). This study was done to study the maternal mortality and morbidity and foetal outcome in pregnant women with severe preeclampsia. This observational study was done in the Department of Obstetrics and Gynaecology, of a tertiary care centre, from the period October 2015 to October 2017.Data was collected from all 130 women attending the antenatal clinic of tertiary care hospital and ward admission and all details such as demographic details, obstetrics examination, and all clinical findings were noted and from that made results. Result: After applying inclusion and exclusion criteria all 130 women were observed in this study.Among 130 women 47 were diagnosed with preeclampsia. Mainly primigravida women were diagnosed with preeclampsia in the 21-25 years group. Among 47 preeclampsia women, 39 women had a BMI of 19-25 kg/m2. Thirty-two of 47 (68.09%) women were diagnosed with preeclampsia around 36-39 weeks. Among all preeclampsia, 28 women out of 47 (59.5%) women delivered babies vaginally, 18 of 47 (38.3%) women delivered through cesarean section, and one of 47 (2.13%) underwent preterm vaginal delivery. In preeclampsia, women's babies were delivered mostly (25/47, 53.19%) ≤2.5 kg weight and only one baby was shifted to NICU because of low birth weight. Preeclampsia increases maternal mortality and morbidity but in this study mortality was not done because our hospital is a tertiary care center with all ICU (intensive care unit) and NICU setup. Preterm births and cesarean deliveries were the mild to severe outcomes that were noted. ICU and NICUhospitalizations as a result of severe complications place a heavy demand on medical facilities. There are firm guidelines for the management of pregnancy-induced hypertension and its complications. For appropriate management, there is careful consideration of various factors, and individual case studies are required.

Correlation between platelet indices and preeclampsia with severe features

Backgrounds: Pre-eclampsia is a pregnancy-related syndrome with a 2-8% prevalence worldwide. In Indonesia, its incidence was 128,273 (5.3%) cases that caused 30-40% of maternal deaths. In 2021, at Karawang General Public Hospital, there are 43% cases of pre-eclampsia with 3% of complication. The pathophysiology is related to the inflammatory and coagulation system that includes platelets. Thus, platelet indices as indicators for platelet changes could be potential laboratory markers for pre-eclampsia.Objective: To examine the relationship between the platelet indices and pre-eclampsia severe features at the Karawang General Public HospitalMethods: The six months cross-sectional study was conducted at the Karawang General Public Hospital for pre-eclampsia pregnant women with at least 28 weeks of gestational age. The pre-eclampsia criteria were blood pressure higher or equal to 140/90 mmHg and qualitative proteinuria dipstick +1. The subjects were divided into two groups: pre-eclampsia with severe features and without severe features. Severe features criteria were thrombocytopenia, impaired liver function, renal insufficiency, pulmonary edema, new onset headache, and visual disturbances. Pregnant women have their blood platelet indices checked in the form of platelet crit (PCT), mean platelet volume (MPV), platelet distribution width (PDW), and platelet large cell ratio (P-LCR). Data were analyzed with descriptive analysis (percentage), cut-off analysis, ROC curve, AUC analysis, bivariate Chi-square analysis, and multivariate logistic regression analysis.Results: There was a significant difference (p &lt; 0.05) in the value of PCT, MPV, PDW, and P-LCR between pregnant pre-eclampsia women with severe features and pregnant pre-eclampsia women without severe features. P-LCR has the best sensitivity (52.9%) and specificity (98.9%).Conclusions: There was a significant change in the value of the platelet indices (PCT, MPV, PDW, P-LCR) in pregnant pre-eclampsia women with severe features at the Karawang General Public Hospital.

Considering belimumab during pregnancy: A more viable option over time.

To share our experience with belimumab in lupus pregnant women and to review the relevant published literature on its use in this scenario. A prospective observational study of pregnant patients with lupus was conducted. Additionally, MEDLINE and EMBASE databases were searched, and a secondary hand search of the literature was performed. Studies were evaluated and visualised descriptively. Sixteen pregnancies of 12 lupus women were included, six (involving eight pregnancies) received belimumab throughout their illness, five of them during some period of gestation. In this group, there was one miscarriage, one elective termination and seven live foetuses (including two live twins). There was one type I intrauterine growth retardation, and a preterm pregnancy due to premature rupture of membranes (PPROM). One mild lupus flare was detected. There were no cases of pre-eclampsia, gestational diabetes mellitus or hypertension. All neonates had normal Apgar scores at birth, none needed critical care. There were no congenital anomalies. After the search, we identified 10 case reports and case series, and five registries. Among the 39 reported cases (41 pregnancies), there were 5 PPROM, 4 pre-eclampsia, and 1 eclampsia. All women made full recoveries. Nineteen new-borns had low birth weight. There were no malformations. While registries did not indicate an increased risk of birth defects or pregnancy loss, there was a higher risk of neonatal infections. Belimumab may be an option for pregnant women with difficult-to-control lupus. Further research is needed to confirm the absence of association between belimumab and foetal harm.

Diagnostic Accuracy of Serum Glycosylated Fibronectin in Prediction of Preeclampsia: A Nested Case-Control Study.

Preeclampsia is a life-threatening complication of pregnancy that occurs in approximately 7% of all pregnancies. In India, the incidence of preeclampsia is 8%-10% and the prevalence is 5.4%, whereas the prevalence of hypertensive disorders of pregnancy is 7.8%. This study was aimed at evaluating the diagnostic accuracy of serum glycosylated fibronectin (S. GlyFn) in the prediction of preeclampsia. A nested case-control study was carried out for 16 months in the department of obstetrics and gynecology. A total of 240 women were recruited and followed after written consent and ethical clearance. Six were lost to follow-up, 15 had second-trimester abortions (excluded from the study), and 32 women developed hypertensive disorders of pregnancy (cases), out of which 1 woman developed antepartum eclampsia, 10 women developed preeclampsia with severe features, and 21 women developed preeclampsia without severe features. One hundred and eighty-seven women remained normotensive throughout the pregnancy until 6 weeks postpartum. After randomization, out of these samples, 54 were analyzed and considered controls. Levels of S. GlyFn were estimated using an ELISA kit using the ELISA technique. The mean S. GlyFn level was significantly higher at the time of enrollment among those women who later developed preeclampsia (127.59 ± 27.68 ng/m) as compared to controls (107.79-53.51 ng/mL). GlyFn at a cutoff value of 126.70 ng/mL significantly (P = 0.034) discriminates cases of preeclampsia with severe features from healthy controls with a sensitivity of 90.00%, a specificity of 63.00%, a 31.03% positive predictive value, and 97.14% negative predictive value. S. GlyFn, at a cutoff value of 126.70 ng/mL, had good sensitivity to discriminate PE from normotensive and was also a good prognostic marker.

Investigating causal relationships between extensive peripheral immune cell phenotypes and preeclampsia: A bi-directional Mendelian randomization analysis.

Preeclampsia, a multifaceted condition during pregnancy characterized by hypertension and organ dysfunction, poses significant risks to both maternal and fetal health. This study aims to investigate the bidirectional causal relationship between peripheral immune cell phenotypes and preeclampsia using a two-sample Mendelian randomization (MR) approach. Genetic data from two sizable cohorts were utilized: 3757 individuals from Sardinia, providing information on 731 immune traits, and 200929 Finnish adult females, encompassing 6663 preeclampsia cases. Single-nucleotide polymorphisms served as instrumental variables. The MR analyses employed the inverse variance-weighted (IVW) method as the primary tool, supplemented by MR-Egger, weighted median, and weighted mode methods to enhance reliability and address potential heterogeneity and horizontal pleiotropy. Among the 731 immune cell phenotypes studied, 18 displayed a suggestive positive association (IVW p<.05) with heightened preeclampsia risk, while 20 exhibited a suggestive negative association linked to reduced risk. Following false discovery rate (FDR) adjustment, four immune phenotypes showed significant associations with decreased preeclampsia risk: CD27 on CD24+ CD27+ B cells (B-cell panel) (odds ratio [OR]=0.927, PFDR=0.061), CD33+ HLA DR+ CD14- absolute count (OR=0.963, PFDR=0.061), CD80 on plasmacytoid dendritic cells (OR=0.923, PFDR=0.061); and CD80 on CD62L+ plasmacytoid dendritic cells (OR=0.923, PFDR=0.061). In the reverse-direction MR analysis, no significant causal effects of preeclampsia on immune cell phenotypes were observed. This study provides quantifiable evidence linking specific immune cell phenotypes to the risk of developing preeclampsia. This novel understanding of the immunological aspects underlying preeclampsia's pathogenesis could lead to innovative therapeutic strategies centered on immune modulation.

The relationship between preeclampsia risk and SENCR rs555172 gene polymorphism and expression.

Preeclampsia, the more severe manifestation of gestational hypertensive disorders, is a major cause of maternal and perinatal morbidity and mortality worldwide. Genetic polymorphisms in long non-coding RNAs (lncRNAs) are considered as potential genetic preeclampsia. This study aimed to explore the association between SENCR rs555172 SNP and PE risk in healthy pregnant women compared to women with preeclampsia. A total of 140 healthy pregnant women and 130 preeclampsia cases were included in the study. The rs555172 genotype was determined using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP), and the expression of the SENCR gene was analyzed in 40 placenta tissue samples from both groups. Various statistical approaches were employed to assess the genotypic and allelic frequencies. The results showed no significant difference in the frequency of the rs555172 polymorphism between healthy pregnant women and those with preeclampsia in terms of the dominant (p=0.82), recessive (p=0.39), and over-dominant (p=0.42) models. Additionally, the analysis of SENCR relative expression revealed no significant difference between the two groups (p=0.48). In conclusion, the LncRNA SENCR rs555172(G/A) seems not associated with an increased risk of Preeclampsia in pregnant women.

Performance of the first-trimester Fetal Medicine Foundation competing risks model for preeclampsia prediction: an external validation study in Brazil

Background: The current version of the Fetal Medicine Foundation competing risks model for preeclampsia prediction has not been previously validated in Brazil.Objectives: (1) To validate the Fetal Medicine Foundation combined algorithm for the prediction of preterm preeclampsia in the Brazilian population and (2) to describe the accuracy and calibration of the Fetal Medicine Foundation algorithm when considering the prophylactic use of aspirin, by clinical criteria.Study design: Cohort study, including consecutive singleton pregnancies undergoing preeclampsia screening at 11-14 weeks, examining maternal characteristics, medical history, and biophysical markers between October 2010 and December 2018 in a university hospital in Brazil. Risks were calculated using the 2018 version of the algorithm available on the Fetal Medicine Foundation website, and cases were classified as low- or high-risk using cut-off of 1/100 to evaluate predictive performance. Expected and observed cases with PE according to the FMF estimated risk range (≥1 in 10; 1 in 11 to 1 in 50; 1 in 51 to 1 in 100; 1 in 101 to 1 in 150; and <1 in 150) were compared. After identifying high-risk pregnant women who used aspirin, the treatment effect of 62% reduction in preterm preeclampsia identified in the ASPRE trial was used to evaluate the predictive performance adjusted for the effect of aspirin. The number of potentially unpreventable cases in the group without aspirin use was estimated.Results: Among 2,749 pregnancies, preterm preeclampsia occurred in 84 (3.1%). With a risk cut-off of 1/100, the screen-positive rate was 25.8%. The detection rate was 71.4%, with a false positive rate of 24.4%. The area under the curve was 0.818 (95% confidence interval 0.773 to 0.863). In the risk range ≥1/10, there is an agreement between the number of expected and observed cases, and in the other ranges, the predicted risk was lower than the observed rates. Accounting for the effect of aspirin resulted in an increase in detection rate and positive predictive values and a slight decrease in the false positive rate. With 27 cases of preterm preeclampsia in the high-risk group without aspirin use, we estimate that 16 of these cases of preterm preeclampsia would have been avoided if this group had received prophylaxis.Conclusions: In a high prevalence setting, the Fetal Medicine Foundation algorithm can identify women who are more likely to develop preterm preeclampsia. Not accounting for the effect of aspirin underestimates the screening performance.

Increased Risk of Gestational Hypertension by Periconceptional Exposure to Ambient Air Pollution and Effect Modification by Prenatal Depression.

Air pollution has been associated with gestational hypertension (GH) and preeclampsia, but susceptible windows of exposure and potential vulnerability by comorbidities, such as prenatal depression, remain unclear. We ascertained GH and preeclampsia cases in a prospective pregnancy cohort in Los Angeles, CA. Daily levels of ambient particulate matters (with a diameter of ≤10 μm [PM10] or ≤2.5 μm [PM2.5]), nitrogen dioxide, and ozone were averaged for each week from 12 weeks preconception to 20 gestational weeks. We used distributed lag models to identify susceptible exposure windows, adjusting for potential confounders. Analyses were additionally stratified by probable prenatal depression to explore population vulnerability. Among 619 participants, 60 developed preeclampsia and 42 developed GH. We identified a susceptible window for exposure to PM2.5 from 1 week preconception to 11 weeks postconception: higher exposure (5 µg/m3) within this window was associated with an average of 8% (95% CI, 1%-15%) higher risk of GH. Among participants with probable prenatal depression (n=179; 32%), overlapping sensitive windows were observed for all pollutants from 8 weeks before to 10 weeks postconception with increased risk of GH (PM2.5, 16% [95% CI, 3%-31%]; PM10, 39% [95% CI, 13%-72%]; nitrogen dioxide, 65% [95% CI, 17%-134%]; and ozone, 45% [95% CI, 9%-93%]), while the associations were close to null among those without prenatal depression. Air pollutants were not associated with preeclampsia in any analyses. We identified periconception through early pregnancy as a susceptible window of air pollution exposure with an increased risk of GH. Prenatal depression increases vulnerability to air pollution exposure and GH.

A new Doppler index, cerebro-placental-uterine ratio, and fetal cardiac parameters in early onset preeclampsia.

Our aim was to investigate the significance of cerebro-placento-uterine ratio CPUR, a new Doppler index, and fetal cardiac parameters (Mod MPI, EFT) in early-onset preeclampsia (EOPE) and to examine whether these parameters are related to perinatal outcome. Forty participants diagnosed with EOPE (preeclampsia cases diagnosed before 34 weeks of gestation) and 40 healthy pregnant women were included in this study. Demographic data were recorded. Doppler parameters such as middle cerebral artery (MCA), umbilical artery (UA), and uterine artery (Ut-A), and left modified myocardial performance index (Mod-MPI) and epicardial fat thickness (EFT) were measured. Cerebroplacental ratio (CPR) was determined by dividing MCA pulsatility index (PI) by UA PI. CPUR was calculated as the ratio of CPR to mean UtA-PI (CPUR = CPR/UtA-PI). All parameters were compared between the EOPE and control groups. Correlation tests were used to examine the relationship between Doppler parameters and perinatal outcome. p values less than 0.05 were considered statistically significant. The pulsatility index of the middle cerebellar artery, CPUR and CPR values were statistically lower in the EOPE group than in the control group (p = 0.002; p = <0.001; p = <0.001; respectively). No statistical differences were found between groups for isovolumetric contraction time (ICT), isovolumetric relaxation time (IRT), ejection time (ET), left mod-MPI, EFT (p = 0.117; p = 0.093; p = 0.398; p = 0.882; p = 0.202, respectively). Umbilical artery Doppler pulsatility index (PI), mean uterine artery Doppler pulsatility index (PI), were higher in the EOPE group than in the control group (p = 0.006; and p = <0.001, respectively). The CPUR value for predicting EOPE was ≤1.3652 with 74. 4% sensitivity and 94.9% specificity. Positive correlations were found between CPUR, CPR, and some neonatal parameters. CPUR, a new index combining fetal and uterine Doppler indices, may add contribution to predict adverse perinatal outcome and EOPE.

Expression of long non-coding RNA GAS5 by first trimester screening predicts the occurrence of gestational hypertension and pre-eclampsia.

Hypertensive disorders of pregnancy (HDP) is a unique disease during gestational period, which is detrimental to pregnancy outcome. This study examined the clinical significance of long non-coding RNA GAS5 in gestational hypertension (GH) and preeclampsia (PE), aiming to explore potential biomarkers for the disease detection. 180 pregnant women with HPD including 90 cases with GH and 90 cases with PE, and another 100 healthy pregnant women were enrolled. Serum GAS5 levels were measured by RT-qPCR method. The diagnostic performance of GAS5 was assessed in GH and PE through plotting receiver operating characteristic (ROC) curve. Logistic regression was applied for the identification of independent factors. Elevated serum GAS5 was identified in GH patients, and its diagnostic performance in discriminating GH cases from healthy people was determined by ROC curve. Serum GAS5 was positively associated with SBP, DBP, LDL-C and CRP values. Cases with PE had an increased serum GAS5 level relative to those with GH. Serum GAS5 was identified to be an independent predictor for PE, and can differentiate PE cases from GH ones. with a good diagnositc performance. Cases with high levels of serum GAS5 had a high risk of poor pregnancy outcomes. Elevated serum GAS5 could serve as an effective diagnostic biomarker in discriminating GH patients from healthy people by first trimester screening. Detection of serum GAS5 level has a certain predictive value for PE.

Risk Factors for Pre-Eclampsia in Pregnant Women at RSUD dr. ABDUL Rivai Berau

Based on medical record data from RSUD dr. Abdul Rivai Berau is known to have 395 cases of pre-eclampsia pregnant women in January-October 2023. Risk factors that play an important role in the occurrence of pre-eclampsia: To determine risk factors for pre-eclampsia in pregnant women was age, parity, history contraceptives and multiple pregnancies. Type of research carried out was quantitative research with an analytical survey research design and a retrospective design. The population is all data pre-eclampsia cases in pregnant women January to October 2023 totaling 395 people, the Slovin formula sample of 199 people was obtained. The sampling technique uses simple random sampling. Data analysis using ch square. Age not at risk 57.8%, multigravida parity 55.3%, no history of using hormonal contraceptives 54.3%, no multiple pregnancies 51.8% and classification of mild pre-eclampsia 54.3%. There is a relationship between age and incidence of pre-eclampsia (p value = 0.009). There is a relationship between parity and incidence of pre-eclampsia (p value = 0.026). There is a relationship between a history of hormonal contraceptive use and the incidence of pre-eclampsia (p value = 0.011). There is a relationship between multiple pregnancies and incidence of pre-eclampsia (p value = 0.014). Age, parity, history of using hormonal contraceptives and multiple pregnancies as risk factors for pre-eclampsia in pregnant women. It is hoped RSUD dr. Abdul Rivai Berau provides health counseling or education to pregnant women preventing pre-eclampsia by providing material related to risk factors for pre-eclampsia in pregnant women along with their treatment and prevention

The association between diet quality index-international and dietary diversity score with preeclampsia: a case–control study

BackgroundPreeclampsia is a significant complication that occurs during the second half of pregnancy. Recent studies have indicated that dietary factors play a crucial role in the development of preeclampsia. The Diet Quality Index-International (DQI-I) and Dietary Diversity Score (DDS) are appropriate indices for assessing the quality of foods, meals, and diets. This study aimed to investigate the relationship between DQI-I, DDS, and preeclampsia.MethodsThis study utilized a case-control design. A total of 90 newly diagnosed preeclampsia cases and 90 healthy controls were included from a referral hospital in Tabriz, Iran. DQI-I and DDS were calculated based on information obtained from a reliable Food Frequency Questionnaire consisting of 168 food items, which assessed participants’ usual diet. Logistic regression analysis adjusted for age, body mass index, education, family history of preeclampsia, and total energy intake was used to estimate odds ratios (ORs).ResultsThe mean age and pre-pregnancy body mass index of the participants were: 27.14 ± 4.40 years and 26.09 ± 3.33 kg/m2, respectively. After adjusting for various confounders, we found significant inverse association between the risk of developing preeclampsia and both DQI-I and DDS. The highest quartile of DQI-I had a significantly lower risk of developing preeclampsia compared to the first quartile (OR = 0.02, 95% CI [0.005, 0.08]) (P < 0.001). Similarly, the highest quartile of DDS had a significantly lower risk of developing preeclampsia compared to the first quartile (OR = 0.09, 95% CI [0.03, 0.31]) (P = 0.001).ConclusionsOur findings suggest that maintaining a high-quality and diverse diet is associated with a lower risk of preeclampsia. Further studies are needed to confirm these associations and explore potential causal relationships.

Clinical study on the difference in intestinal microecology between patients with preeclampsia and pregnant women at different stages of pregnancy.

Objective: To explore the difference in intestinal microecology between patients with preeclampsia and pregnant women at different stages of pregnancy. Methods: From January 2020 to January 2022, clinical data, including blood routine, lipid profile, and renal function indicators, were gathered from a cohort consisting of 5 cases of preeclampsia and 34 cases of non-preeclampsia. The non-preeclampsia group was further categorized into 6 cases in the First trimester, 13 cases in the Second trimester, and 15 cases in the Third trimester. The data collection took place at the Obstetrics Department of the Maternal and Child Health Hospital of Hubei Province. Additionally, fecal samples were obtained from each subject for 16S rDNA gene sequencing and subsequent analysis. The clinical data and composition characteristics of the gut microbiota in each group were analyzed, and the correlation between gut microbiota and clinical data was analyzed by the Spearman correlation analysis method. Results: In comparison to pregnant women without preeclampsia, preeclampsia patients exhibited a statistically significant elevation in blood routine parameters (WBC, N, L, and PLT count), a rise in lipid-related indicators (TC, TG, and LDL-C levels), a reduction in HDL-C levels, and an increase in renal function-related indicators (Cr, BUN, UA and Pro levels). Compared with non-preeclampsia pregnant women, preeclampsia women exhibited an augmented diversity of gut microbiota. Differences in gut microbiota composition between the two groups were observed at the gate and genus levels. Moreover, there are significant differences in the composition of gut microbiota between the preeclampsia group and the third-trimester group in terms of genus and species, and this difference is mainly caused by Prevotella and s_ Bacteroides_ Uniformis and Ruminococcus_ bromii. In addition, actinobacteria, bifidobacterium at the genus level, and Ruminococcus_bromii at the species level are positively correlated with clinically relevant indicators (excluding HDL-C). Conclusion: There are significant differences in gut microbiota between preeclampsia pregnant women and late pregnancy pregnant without preeclampsia, including Prevotella and Bacteroides_ Uniformis, and Ruminococcus_ bromii. In addition, these differential bacteria are correlated with most clinical indicators. However, additional comprehensive analysis is required to ascertain the functional correlation between these bacteria and clinical indicators.

Abstract 40: Causal Aspects of Preeclampsia and Gestational Hypertension for Risk of Future Cardiovascular Diseases

Introduction: Preeclampsia is a multifactorial disease and a cause of maternal and neonatal morbidity and mortality. Observational studies show that women with preeclampsia have increased risk of cardiovascular diseases later in life. Whether this association is causal is however uncertain. Hypothesis: We assessed the hypothesis that preeclampsia and gestational hypertension are causal risk factors for future cardiovascular diseases, including ischemic heart disease, myocardial infarction, stroke, ischemic stroke, atrial fibrillation, and heart failure. Methods: For this purpose, we performed one-sample Mendelian randomization (MR) analyses using individual level data from 202,876 white British women from the UK Biobank. Subsequently, two-sample MR analyses were performed using summary level data from FinnGen and from the to date largest consortia for each endpoint individually and then pooled in fixed-effects meta-analyses. Genetic instruments for preeclampsia and gestational hypertension were from the most updated genome-wide association study (n=20,064 preeclampsia cases; n=703,117 controls; n=11,027 gestational hypertension cases; n=412,788 controls). Results: In one-sample MR analyses, the odds ratios (95% CI) for preeclampsia were 1.26 (1.11-1.43) for ischemic heart disease, 1.26 (0.99-1.60) for myocardial infarction, 1.28 (1.04-1.57) for stroke, and 1.37 (1.08-1.74) for ischemic stroke; for gestational hypertension the odds ratios (95% CI) were 1.17 (1.07-1.28) for ischemic heart disease, 1.16 (0.98-1.36) for myocardial infarction, 1.35 (1.17-1.56) for stroke, 1.36 (1.15-1.60) for ischemic stroke, 1.16 (1.04-1.29) for atrial fibrillation, and 1.22 (1.04-1.43) for heart failure. The two-sample MR analyses confirmed all associations from one-sample MR analyses with similar results from multiple sensitivity analyses. The MR-Egger results did not suggest pleiotropy. Conclusion: Genetic predisposition to preeclampsia or gestational hypertension was associated with increased risk of cardiovascular diseases later in life, suggesting preeclampsia as a likely causal factor.