Factors In Preeclampsia Research Articles

DIFFERENTIATION FACTORS OF M1 AND M2 SUBPOPULATIONS OF DECIDUAL MACROPHAGES IN PREGNANT WOMEN WITH PREECLAMPSIA, THEIR IMBALANCE AND WAYS TO CORRECT IT

According to the literature, inappropriate polarization of decidual macrophages is associated with abnormal pregnancy conditions such as spontaneous abortion, premature childbirth, preeclampsia, foetal growth retardation, etc.; therefore, studying the relationship between subpopulations of decidual macrophages and factors promoting their production in women with preeclampsia is of great clinical relevance. The purpose of this study was to identify the features of differentiation in subpopulations M1 and M2 of decidual macrophages in pregnant women with preeclampsia and to assess the impact of factors promoting their induction. Materials and methods. The concentrations of pro- and anti-inflammatory cytokines (TNF-α, INF-γ, IL-10) and the activity of iNOS and arginase in cervical mucus in pregnant women with preeclampsia were studied in comparison with the corresponding indicators in healthy pregnant women, with subsequent comparison of these indicators with the number of decidual macrophages M1 and M2 in the placentas of the examined women. We determined the concentration of cytokines by using immunoassay. NO synthase activity was determined by the difference in nitrite concentration before and after cervical mucus incubation. The total arginase activity was assessed by the difference in the concentration of L-ornithine before and after incubation in phosphate buffered saline, which contained L-arginine. Immunohistochemical study of macrophages M1 and M2 in placental tissue was carried out in the pathomorphological laboratory "CSD Health Care" (Kiev). A total of 62 pregnant women were examined: the control group included 30 healthy pregnant women who did not have risk factors for preeclampsia and unimpaired circulation in the uterine spiral arteries in the area of ​​the placental site at 18-20 + 6 weeks of gestation. The study group included 32 pregnant women at high risk to develop preeclampsia, with impaired circulation in the uterine spiral arteries in the area of ​​the placental site at 18-20 + 6 weeks of gestation; 14 of them then developed preeclampsia. Results. In pregnant women with preeclampsia, the balance of pro- and anti-inflammatory cytokines is impaired in favour of TNF-α and INF-γ with a decrease in IL-10 content that results in an imbalance in the activity of enzymes regulating the L-arginine metabolism with the following increase in iNOS activity. The activity of arginine is significantly reduced. In the placentas of women with preeclampsia, the content of decidual macrophages M1 phenotype is 1.7 times higher than their number in healthy women, while the content of macrophages M2 phenotype, on the contrary, goes down in 1.5 times. The study has shown that the predominance of decidual M1 macrophages in women with preeclampsia occurs due to the stimulating effect of INF-γ and the activation of inducible NO-synthase. This imbalance of decidual macrophages in favour of the M1 subpopulation is likely to cause the progression of endothelial dysfunction, manifestation of preeclampsia, and dysfunction of the placenta in the second trimester and in the early phase of the third trimester of gestation.

Preeclampsia for the Nephrologist: Current Understanding in Diagnosis, Management, and Long-term Outcomes.

Preeclampsia is a multisystem progressive disorder of pregnancy that can be potentially catastrophic for the mother and the fetus. It involves complex perturbations of the kidney and systemic physiology, along with long-term effects on vascular and kidney health. Thus, the nephrologist plays a key role in the peripartum and long-term management of preeclampsia. Recent translational research has improved our understanding of its pathophysiology, and there is hope for novel therapies. In this review, we discuss the evolution of diagnostic criteria and dilemmas in the diagnosis of hypertensive disorders in pregnancy. We summarize the advances in the pathogenesis and prediction of preeclampsia. We describe the management and prevention of preeclampsia focusing specially on the forthcoming strategies from the nephrologist's perspective. We address the evidence regarding long-term outcomes for the mother and the child. We end with exploring areas warranting future research.

The effect of parity, history of preeclampsia, and pregnancy care on the incidence of subsequent preeclampsia in multiparous women with SLE

Objectives To clarify the correlation between preeclampsia and parity and to identify protective factors against preeclampsia in multiparous women with systemic lupus erythematosus (SLE). Methods We conducted a single-center, retrospective chart review study of 85 pregnant women. We used multiple logistic regression analysis to assess the association between parity and preeclampsia in women with SLE, and described the detailed clinical courses and management of four women with a history of severe preeclampsia and of a woman who experienced preeclampsia during her latest pregnancy. Results Multiparity was significantly associated with a low risk of preeclampsia (adjusted odds ratio: 0.08; 95% confidence interval: 0.01–0.95). One multiparous woman without a history of preeclampsia developed preeclampsia during her latest pregnancy; she had critical risk factors for preeclampsia, including chronic kidney disease and hypertension, and was not administered aspirin. In contrast, four multiparous women with a history of severe preeclampsia received adequate medications; they did not develop recurrent preeclampsia and delivered live newborns. Conclusions Multiparity and maintenance therapy for SLE before and during pregnancy and preventive treatment for preeclampsia may improve outcomes in subsequent pregnancies.

Assessment of the Risk Factors for Preeclampsia in Primigravida Mothers in and Around Karad, India- An Observational Study

Assessment of the Risk Factors for Preeclampsia in Primigravida Mothers in and Around Karad, India- An Observational Study

MiR-483 is downregulated in pre-eclampsia via targeting insulin-like growth factor 1 (IGF1) and regulates the PI3K/Akt/mTOR pathway of endothelial progenitor cells.

Pre-eclampsia is a serious pregnancy-specific disease with an incidence of 9.4%. MicroRNAs play a key role in regulating factors in pre-eclampsia, but related research is still limited. This study aims to reveal the role and potential mechanisms of miR-483 in pre-eclampsia. miR-483 was detected in venous blood, umbilical cord blood and placental tissue of pre-eclampsia patients by Real-time Quantitative polymerase chain reaction (qRT-PCR). Insulin-like growth factor (IGF1) and miR-483 were detected by qRT-PCR and western blot in endothelial progenitor cells isolated from fetal umbilical cord blood. miR-483 was overexpressed and inhibited to detect changes of IGF1 and PI3K/Akt/mTOR pathway in endothelial progenitor cells by qRT-PCR and western blot. miR-483 was downregulated in venous blood, umbilical cord blood and placental tissue of pre-eclampsia patients. In endothelial progenitor cells, overexpression of miR-483 inhibited the expression of IGF1, and inhibition of miR-483 promoted the expression of IGF1. miR-483 regulates the expression of PI3K, Akt, and mTOR in endothelial progenitor cells. miR-483 is downregulated in pre-eclampsia and regulates endothelial progenitor cells by targeting IGF1. miR-483 is a potential alternative for diagnosing and treating pre-eclampsia.

Risk Factors of Preeclampsia among Pregnant Women in Khorramabad (West of Iran)

Background: Preeclampsia occurs in 2-10% of pregnancies, worldwide, and is characterized as a combination of hypertension and proteinuria. Objective: The purpose of this study is to determine the risk factors associated with the incidence of preeclampsia in the west of Iran and associated factors. Methods: This is a cross sectional study that was performed on 740 pregnant women between 2014- 2017, who were referred to different health care centers of Khorramabad. The data was collected from these centers and a questionnaire was filled for every woman that included age, height, gender of the neonate, number of pregnancies, multiparity, season of the pregnancy, birth weight, mothers’ body mass index (BMI) before delivery, smoking history and diagnosis of preeclampsia. The data obtained was statistically analyzed using SPSS software. Results: Of the 760 subjects included, 1.1% (8 cases) were reported to be presented with preeclampsia. We found a significant difference between non pre-eclamptic and pre-eclamptic patients in terms of BMI (p=0.006), number of pregnancies (p<0.05), maternal age (p<0.05) and weight (p=0.004). With an increase in BMI and the number of pregnancies, the risk of preeclampsia was elevated. Pre-eclamptic mothers had higher body weight than non-pre-eclamptic ones (75.9 kg vs. 65.6 kg) and the prevalence of preeclampsia increased with age. Conclusion: The prevalence of preeclampsia was seen to be positively associated with higher BMI, pregnancy rate, mother weight and age are associated with higher prevalence of preeclampsia.

Complicaciones obstétricas en gestantes trabajadoras

Objetivo: Determinar el riesgo de complicaciones obstétricas en gestantes trabajadoras atendidas en la Maternidad “Dr. Armando Castillo Plaza” de Maracaibo, estado Zulia. Métodos: Investigación comparativa, con diseño no experimental y transeccional, que incluyó 100 gestantes trabajadoras (casos) y 100 no trabajadoras (controles); evaluándoseles el riesgo de presentar complicaciones obstétricas como preeclampsia, prematuridad, bajo peso al nacer y malformaciones congénitas. Resultados: Prevalecieron trabajadoras de los servicios y vendedores de comercio y mercado (31%) y ocupaciones elementales (20%), contratadas (74%), con antigüedad entre 2-5 años (56%), trabajo en bipedestación (62%), alta-media demanda física o mental (73% y 57%, respectivamente), alta demanda laboral (51%), alta satisfacción laboral (68%), y expuestas a riesgos ergonómicos como esfuerzo físico pesado (51,8%). Se encontró que 44% de las pacientes presentaron alguna complicación obstétrica, aunque en las trabajadoras hubo mayor número de complicaciones que en las no trabajadoras, la presencia de cualquier complicación fue similar y no mostró diferencias significativas (41% vs. 47%, respectivamente; OR [IC95%]= 0,783 [0,447 – 1,371]; p> 0,05). Aunque no constituyó un factor de riesgo, sólo el parto pretérmino predominó en las gestantes trabajadoras, aunque no re (10% vs. 1%; OR [IC95%]= 0,090 [0,011 - 0,724]; p= 0,009); mientras que la presencia de preeclampsia ocurrió mayormente en las no trabajadoras (8% vs. 16%, respectivamente; OR [IC95%]= 2,191 [0,892 – 5,381]; p> 0,005), representando el no tener la condición laboral un factor protector para no presentar preeclampsia, aunque no significativo. Conclusión: La condición laboral no genera mayor riesgo de presentar complicaciones en las gestantes.

Placental growth factor in suspected preterm pre-eclampsia: a review of the evidence and practicalities of implementation.

Despite extensive research, the pathophysiology and prevention of pre-eclampsia remain elusive, diagnosis is challenging, and pre-eclampsia remains associated with adverse maternal and perinatal outcomes. Angiogenic biomarkers, including placental growth factor (PlGF) and soluble fms-like tyrosine kinase 1 (sFlt-1), have been identified as valuable biomarkers for preterm pre-eclampsia, accelerating diagnosis and reducing maternal adverse outcomes by risk stratification, with enhanced surveillance for high-risk women. PlGF-based testing is increasingly being implemented in clinical practice in several countries. This review provides healthcare providers with an understanding of the evidence for PlGF-based testing and describes the practicalities and challenges to implementation. TWEETABLE ABSTRACT: Placental growth factor in pre-eclampsia: evidence and implementation of testing.

Leptin receptor gene polymorphisms c.668A>G and c.1968G>C in Sudanese women with preeclampsia: a case-control study

BackgroundLeptin receptor gene (LEPR) variants may affect the leptin levels and act as a risk factor for preeclampsia. Two LEPR gene missense variants rs1137101 (c.668A>G) and rs1805094 (c.1968G>C) were investigated in Sudanese women with preeclampsia.MethodsA matched case-control study (122 women in each arm) was conducted in Saad Abualila Maternity Hospital in Khartoum, Sudan from May to December 2018. The cases were women with preeclampsia and the controls were healthy pregnant women. Genotyping for LEPR gene variants c.668A>G and c.1968G>C was performed using polymerase chain reaction-restriction fragment length polymorphism. Logistic regression models (adjusted for age, parity, body mass index and hemoglobin level) were conducted.ResultsGenotype frequency of LEPR gene variants c.668A>G and c.1968G>C was in accordance with Hardy–Weinberg equilibrium (P > 0.05) in the controls. Allele G in LEPRc.668A>G variant was significantly more frequent in the cases compared with the controls [43.4% vs. 10.2%; OR = 6.44; 95%CI (3.98–10.40); P < 0.001]. In variant LEPRc.668A>G, genotype AG was the prevalent genotype in the cases compared with the controls, and it was significantly associated with preeclampsia risk [37.7% vs. 15.5%; AOR = 3.48; 95%CI (1.15–10.54); P = 0.027]. Likewise, the GG genotype was the second most common genotype in the cases compared with the controls, and was associated with preeclampsia risk [24.6% vs. 2.5%; AOR = 14.19; 95%CI (1.77–113.76); P = 0.012]. None of the LEPRc.1968G>C variant genotypes were associated with preeclampsia. The CC genotype was not detected in neither the cases nor the controls. The haplotype A-G 70.1% was the prevalent haplotype in this population, and it significantly protected against preeclampsia [OR = 0.14; 95%CI (0.09–0.23); P < 0.001]. However, the haplotype G-G 26.8% was significantly associated with preeclampsia risk [OR = 6.70; 95%CI (4.16–11.05); P < 0.001]. Both variants c.668A>G and c.1968G>C were in strong linkage disequilibrium (D′ = 1, r2 = 0.012).ConclusionsOur data indicate that the rs1137101 (c.668A>G) variant and G-G haplotype may independently associate with the development of preeclampsia.

The Effects of Isolated Proteinuria Detected After 20 Weeks of Pregnancy on Perinatal Outcomes

Proteinuria is a component of preeclampsia, and the presence of proteinuria without an increase in blood pressure can precede preeclampsia. This study aims to investigate the perinatal effects of isolated proteinuria detected in a 24-h urine sample after the 20th week of pregnancy. This is a prospective study of the perinatal outcomes of 60 pregnancies without proteinuria and matched 58 pregnancies with isolated proteinuria in patients consecutively admitted to the department of obstetrics at a university hospital in Turkey. The pregnant patients with proteinuria and without proteinuria were statistically similar with respect to age, gravidity, parity and the number of living children on enrolment. There were no significant differences in terms of gestational age at enrolment, gestational age at delivery, or intrauterine growth restriction (IUGR) between patients with isolated proteinuria and patients without proteinuria. However, preeclampsia developed significantly more frequently in patients with isolated proteinuria (20.6% vs 6.6%, p = 0.048). There were no significant differences in terms of newborn weight, Apgar scores, need for the neonatal intensive care unit (NICU), or umbilical artery blood pH in patients with proteinuria and without proteinuria. Isolated proteinuria after 20 weeks of pregnancy does not appear to impair maternal or foetal outcomes. Identifying pregnant women with risk factors for preeclampsia, ensuring they attend meticulous follow-up schedules and performing their delivery at tertiary health care centres would help to improve maternal and foetal morbidity and prevent perinatal mortality.

Adherence to a Dietary Approaches to Stop Hypertension (DASH)-style Diet in Relation to Preeclampsia: A Case-Control Study

Maternal diet is an important potential factor associated with the risk of preeclampsia. However, it is unclear whether adherence to a Dietary Approaches to Stop Hypertension (DASH)-style diet can reduce the development of preeclampsia. To examine the potential association, we conducted a hospital-based case-control study at the First Affiliated Hospital of Zhengzhou University, China. A total of 449 cases with preeclampsia and 449 controls were studied. Dietary information was collected using a validated food frequency questionnaire (FFQ). DASH scores were calculated according to nutrients/food emphasised or minimised in the DASH diet. The calculated DASH scores ranged from 11 to 38 for all of the participants, and the DASH scores of the cases were significantly lower than those of the controls (23.48 ± 4.58 vs 24.51 ± 4.51; p = 0.001). Participants in the fourth quartile of the DASH score were 45% less likely to have preeclampsia than those in the first quartile in the crude model (Q4 vs Q1, odds ratio [OR]: 0.55; 95% confidence interval [CI]: 0.38, 0.80; ptrend = 0.001). The relationship remained significant in the model adjusted for multiple confounders, especially for major risk factors of preeclampsia (OR: 0.53; 95% CI: 0.36, 0.78; ptrend = 0.001). Our findings suggest an inverse relationship between adherence to a DASH-style diet and the odds of preeclampsia. Further larger-scale cohort studies or randomised controlled trials are warranted to confirm these relationships.

An Insight into the Angiogenic and Lymphatic Interplay in Pre-eclampsia Comorbid with HIV Infection.

To provide insight on the imbalance of angiogenic and lymphangiogenic factors in pre-eclampsia, as well as highlight polymorphism in genes related to angiogenesis and lymphangiogenesis. The pregnancy-specific disorder pre-eclampsia is diagnosed by the presence of hypertension with/without proteinuria, after 20weeks of gestation. The pathogenesis of pre-eclampsia remains ambiguous, but research over the years has identified an imbalance in maternal and foetal factors. Familial predisposition and gene variation are also linked to pre-eclampsia development. The sFlt-1/PIGF ratio has attracted great attention over the years; more recently several researchers have reported that a sFlt-1/PIGF ratio of ≤ 38 can be used to predict short-term absence of pre-eclampsia. This ratio has the potential to prevent adverse pregnancy outcomes and reduce healthcare costs significantly. Genome-wide studies have additionally identified variation in the foetal gene near Flt-1. The development of preeclampsia is not limited to the maternal interface, but foetal involvement as well as genetic interplay is associated with the disorder.

Relationship between polymorphisms of CXCL3 gene and preeclampsia

Background Preeclampsia (PE), a pregnancy-specific disease, is a main cause of maternal and perinatal mortality in the world, the exact pathogenesis of which is still unknown. Recent studies have found it is a disorder caused by multiple factors and genes. Previously, we found a significantly abnormal expression of CXCL3 in plasma and placenta of severe preeclampsia. Here, we intend to explore the association of polymorphisms in CXCL3 gene with preeclampsia susceptibility in women from western China. Methods Four hundred eighty-one pregnant women were involved in this case-control study, including 83 early-onset severe preeclampsia cases, 114 late-onset severe preeclampsia cases, 41 mild preeclampsia cases and 243 normal pregnancies. The rs370655 variant in CXCL3 was detected by the method of polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). Results No significantly reduced risk of preeclampsia is observed in the rs370655 AA genotype compared with other genotypes (AG versus AA: OR = .82, 95%CI = .54–1.26; GG versus AA: OR = .95, 95%CI = .56–1.61). After subgroup analysis, there are still no significant differences among various genotypes in the mild preeclampsia, early-onset severe preeclampsia and late-onset sever preeclampsia. Conclusion Our study suggests that rs370655 polymorphism in CXCL3 gene may be not the risk factor of preeclampsia, exploring other consequential SNPs in CXCL3 gene may help to predict the preeclampsia.

Hypoalbuminemia as a Risk Factor for Preeclampsia in the Pregnant Hypertensive Population

Hypoalbuminemia as a Risk Factor for Preeclampsia in the Pregnant Hypertensive Population

Association of CYP11B2 gene polymorphism with preeclampsia in north east of Iran (Khorasan province)

PurposeIdentification the genetic factors in preeclampsia (PE) are useful to increase the current knowledge of the pathophysiology of the disorder. The genetic factors implicated for all cases of PE remain to be determined. This study was aimed to investigate association between ADD1 1378G > T, AGTR2 1675G > A, AGTR1 1166A > C, NOS3 894 G > T and CYP11B2 −344C > T gene polymorphisms in Iranian women with PE. Material and Methods117 pregnant women with PE and 103 healthy women without affected previous pregnancy by PE were selected. Genomic DNA was extracted from peripheral blood and real-time PCR was performed to investigate the polymorphisms using a commercial kit. ResultsThere was a significant difference in CYP11B2 −344C > T gene polymorphism between case and control groups (P = 0.025). The odds ratio was 0.71 (CI 95% = 0.28–1.79). There were no statistical significant differences between other genetic polymorphisms. ConclusionOur results showed a significant association between CYP11B2 −344C > T gene polymorphism with PE. This finding suggests that mentioned polymorphism may be associated with susceptibility to PE at least in IRAN.

Preeclampsia in women with pregestational diabetes – a cohort study

ABSTRACTAims: To evaluate risk factors for preeclampsia (PE) in women with pregestational diabetes.Methods: Retrospective cohort study of women with pregestational diabetes cared for at a specialized prenatal care facility. Maternal characteristics at booking and during pregnancy were studied for their association with preeclampsia. Multivariable models were tested using Poisson regression with robust estimates; results were expressed as relative risk (RR) and 95% confidence interval (CI).Results: Preeclampsia was diagnosed in 62 of 206 women (30%, 95% CI 24–37%). Previous chronic hypertension was found in 53 subjects (26%; 95% CI 20–32%), of whom 41 (77%, 95% CI 64–88) were type 2 women. Type 1 diabetes, chronic hypertension, systolic blood pressure >124 mmHg at booking and gestational weight gain, either total or excessive for body mass index category, behaved as independent risk factors.Conclusions: In women with pregestational diabetes, some risk factors may predict PE, similar to those found in non-diabetic pregnant women. Two non-modifiable factors (type of diabetes and chronic hypertension) and two modifiable ones (systolic blood pressure levels and gestational weight gain) were found relevant in this cohort. A policy of close monitoring of blood pressure and weight gain, aiming adequate weight gain, may be added to current recommended measures. The high prevalence of PE in women with prepregnancy diabetes, especially those with initial pregnancy systolic blood pressure >124 mmHg, supports a policy of early institution of low dose aspirin. Further multicentric studies will help define the role of these risk factors as contributors to PE in pregestational diabetes.

Assessment of \u03b2-human-derived chorionic gonadotrophic hormone (\u03b2hCG) and pregnancy-associated plasma protein A (PAPP-A) levels as predictive factors of preeclampsia in the first trimester among Iranian women: a cohort study

BackgroundPreeclampsia (PE) is a leading cause of maternal and perinatal mortality. There are controversial findings regarding the prediction of PE through the assessment of the Pregnancy-Associated Plasma Protein A (PAPP-A) and β-Human-Derived Chorionic Gonadotrophic hormone (βhCG) levels in the first trimester of pregnancy. Therefore, this cohort study was conducted to evaluate of PAPP-A and βhCG levels as predictive factors for PE development in the first trimester among Iranian women.MethodsIn this cohort study, a total of 4605 volunteer Primigravida and Multigravida women were selected by the census from 16 randomly selected Health Centers in Isfahan, Iran, from July 2016 to June 2018. Eligible pregnant women participated in the study had already undergone fetal anomalies screening tests between 11 + 0 and 13 + 6 weeks of pregnancy and their PAPP-A and βhCG biomarkers were adjusted to the Multiples of the Median (MOM). MOM PAPP-A < 0.4 and MOM βhCG > 3 were considered abnormal. The samples were followed up until delivery. The biomarkers’ levels were compared in the two groups of women with and without PE and Relative risk (RR) and odds ratio (OR) of PE calculated.ResultsIn the PE group, the mean MOM PAPP-A was significantly lower (1 vs. 1.09 with P = 0.006) and MOM βhCG was significantly higher (1.51 vs. 1.14 with P = 0.001) than the group without PE. RR and OR for PE in subjects with MOM PAPP-A < 0.4 were reported as follows: RR = 2.49, (p = 0.001) and OR = 2.09, (p = 0.001). RR and OR for PE in subjects with MOM βhCG > 3 were also reported as follows: RR = 4.02, (p = 0.001) and OR = 5.65, (p = 0.001). Adjusted OR for MOM PAPP-A < 0.4 and MOM βhCG > 3 was obtained as follows: OR = 2.09 (P = 0.001) and OR = 5.65 (P = 0.001), respectively.ConclusionThe results of the study showed that the high levels of βhCG would cause 5.65 times increase and the low levels of PAPP-A would cause 2.09 times increase in the chance of developing PE.

Pre-existing medical disorders as risk factors for preeclampsia: an exploratory case-control study

ABSTRACTObjective: We sought to explore pre-existing medical disorders as risk factors for preeclampsia as thoroughly as possible.Methods: A case-control design. A group of 1,652 patients were identified as the preeclampsia group, and another randomly selected 4,500 patients were identified as the non-preeclampsia group.Results: Mature ovarian teratoma (adjusted odds ratio [OR] 7.69, 95% CI 1.58–37.53), uterine fibroids (adjusted OR 2.24, 95% CI 1.28–3.92) and pregestational hypothyroidism (adjusted OR 5.17, 95% CI 2.43–11.00), were significantly correlated with preeclampsia.Conclusions: Mature ovarian teratoma, uterine fibroids and pregestational hypothyroidism may also contribute to the incidence of preeclampsia.

Identification of key transcription factors in preeclampsia

ABSTRACTObjective: The aim of this study was to identify important transcription factors (TFs) in preeclampsia.Methods: Fisher’s test was applied to identify differentially expressed pathways. Functional principal component analysis (FPCA) was applied to identify differential expressed genes (DEGs). Topological characterizations of TFs were analyzed to identify key TFs.Results: From the DEG group, 37 genes were identified as TFs, and a total of 10 significant TFs with adjusted p<0.05 were identified. A total of 17 key TFs were identified from the TF network.Conclusions: Seventeen key TFs were identified, which may provide new insights into the mechanism of preeclampsia.

Urinary placental growth factor in preeclampsia and fetal growth restriction: An alternative to circulating biomarkers?

To correlate plasma and urinary soluble fms-like tyrosine kinase 1 (sFlt-1) and placental growth factor (PIGF) in preeclampsia (PE) and fetal growth restriction (FGR) and assess the performance in detecting established disease. A cross-sectional case-control study recruited 26-40 weeks gestation pregnancies into four clinical groups: normal pregnancy, PE, PE + FGR, and FGR. enzyme-linked immunosorbent assay (ELISA) measurements of urinary and plasma sFlt-1 and PlGF levels were performed. Urinary levels of sFlt-1 and PIGF were normalized to creatinine. Spearman's rank correlation was used to assess the association between plasma and urinary levels of sFlt-1 and PIGF, and receiver operating characteristic graphs were used to quantify the performance of each individual marker and their ratios in predicting normal versus pathological pregnancies affected by preeclampsia and/or FGR. There was a significant correlation between plasma PlGF and urinary PlGF (r = 0.718, P < 0.001) in all groups. In the pathological groups, plasma sFlt-1 and urinary sFlt-1 as well as plasma sFlt-1: PIGF ratio and urinary sFlt-1: PlGF ratio were higher, but plasma PIGF and urinary PlGF were lower when compared to normal pregnancy. Plasma PIGF and plasma sFlt-1: PlGF ratio was comparable in performance to urinary PlGF and urinary sFlt-1: PIGF ratio for the diagnosis of preeclampsia and/or FGR. Urinary PIGF can be used as an alternative to circulating biomarkers in preeclampsia and FGR. Plasma sFlt-1, PlGF and sFlt-1: PlGF ratio as well as urinary PIGF and sFlt-1: PlGF ratio can be used to differentiate between normal pregnancy and pregnancies complicated by preeclampsia and FGR.