Preeclampsia linked with higher risk of preterm delivery and later-life vascular disease

June 03, 2002

TORONTO, June 3 - Every six minutes, a woman dies of a pregnancy complication called preeclampsia - nine women an hour, according to the Preeclampsia Foundation. The disorder, which is linked to hypertension and affects 3 million women a year worldwide, can be equally devastating for infants.

Now, research being presented at the 13th World Congress of the International Society for the Study of Hypertension in Pregnancy by scientists from the Magee-Womens Research Institute and the University of Pittsburgh School of Medicine suggests that preeclampsia may be linked to increased risk of preterm delivery and later-life hypertension and cardiovascular disease.

"Research is closing in on this menace," said James M. Roberts, M.D., professor and chairman of research in the department of obstetrics, gynecology and reproductive sciences at the University of Pittsburgh School of Medicine, director of Magee-Womens Research Institute, and president of the International Society for the Study of Hypertension in Pregnancy. "But there is still much to do."

Carl A. Hubel, Ph.D., assistant professor of obstetrics, gynecology and reproductive sciences at the University of Pittsburgh School of Medicine, and his colleagues found that blood concentrations of a metabolic sugar called sialic acid are increased in women who develop preeclampsia with preterm delivery, but not term delivery. By studying blood samples from pregnant women who had experienced preeclampsia in a prior pregnancy, Dr. Hubel's group found that preeclampsia that takes place in preterm is generally more severe than that which develops later, and is more likely to be associated with fetal growth restriction.

In addition, "elevated levels of sialic acid indicate inflammation and are associated with an increased risk of atherosclerosis, or stiffening of the blood vessels," said Dr. Hubel, who also is an investigator at the Magee-Womens Research Institute in Pittsburgh.

Dr. Hubel's study randomized women into two groups, who received either 60 milligrams of aspirin, an anti-inflammatory drug, or a placebo daily. Early results of the study indicate that low-dose aspirin may lessen this inflammatory response.

In another study, Roberta Ness, M.D., M.P.H., associate professor of epidemiology and obstetrics, gynecology and reproductive sciences at the University of Pittsburgh School of Medicine, and her colleagues found that women who have had preeclampsia may continue to be at increased risk for vascular-related disease throughout their lives.

Working with graduate student Patricia Agatisa, Dr. Ness studied stress heart rate, blood pressure and forearm blood flow in pregnant women who had a prior preeclampsia, women with normal pregnancies and never-pregnant women. Investigators found that having a normal pregnancy is associated with a positive long-term effect on blood vessel behavior that is not present in women who had a previous preeclamptic pregnancy or in those who had never been pregnant.

The absence of this effect may point to increased risk for hypertension and cardiovascular disease later in life, Dr. Ness noted.

Women who have previously experienced preeclampsia, also known as toxemia and characterized by high blood pressure, swollen ankles and the presence of protein in the urine, have an even greater chance of developing the disorder in subsequent pregnancies. Other risk factors include maternal age of less than 25 or more than 35 years and preexisting hypertension, diabetes or kidney disease.

"Preeclampsia is one of the leading causes of maternal, fetal and neonatal disability and death," said Dr. Roberts.
-end-
Magee-Womens Research Institute, the country's first institute devoted to women and infants, was formed in 1992 by Magee-Womens Hospital of the UPMC Health System. The University of Pittsburgh School of Medicine's department of obstetrics, gynecology and reproductive sciences is one of the top three funded departments by the National Institutes of Health nationwide.

Members of the International Society for the Study of Hypertension in Pregnancy meet formally every two years to exchange ideas and foster collaboration. Membership includes physicians and researchers in the fields of obstetrics, gynecology, epidemiology and other public health specialties.

Note to editors: To arrange an interview with Drs. Roberts, Ness or Hubel, please call Michele Baum or Kathryn Duda at 412-647-3555.

CONTACT:
Michele D. Baum
Kathryn Duda
PHONE: (412) 647-3555
FAX: (412) 624-3184
E-MAIL:
BaumMD@msx.upmc.edu
DudaK@msx.upmc.edu

University of Pittsburgh Medical Center

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