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Evidence of Endothelial Dysfunction in Preeclampsia and Risk of Adverse Pregnancy Outcome

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Abstract

The purpose of this study is to investigate whether endothelial dysfunction, as assessed by elevated cellular fibronectin (cFN), in women with preeclampsia is associated with an increased risk of preterm and/or small-for-gestational-age (SGA) births. Maternal plasma cFN was measured by enzyme-linked immunosorbent assay in samples collected at admission to delivery in 605 normotensive women, 171 women with transient hypertension, and 187 women with preeclampsia. Logistic regression was used to estimate the risk for preterm delivery, SGA, or both. Elevated cFN in women with preeclampsia was associated with an increased risk of both preterm and SGA births (odds ratio, 3.0; confidence interval [CI], 1.0–.7) compared with women with preeclampsia without elevated cFN. The risk of preterm birth was 14.7-fold higher (CI, 8.1–26.7) and the risk of SGA was 6.8-fold higher (CI, 3.5–13.1) in women with preeclampsia, hyperuricemia, and elevated cFN compared with normotensive women. Elevated cFN is prevalent among women with preeclampsia and identifies women at increased risk of preterm delivery and SGA.

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References

  1. Roberts JM Pregnancy related hypertension. In: Creasy RK, Resnik R, eds. Maternal Fetal Medicine. Philadelphia, PA: WB Saunders; 1998:833–872.

    Google Scholar 

  2. Duley L. Maternal mortality associated with hypertensive disorders of pregnancy in Africa, Asia, Latin America and the Caribbean. Br J Obstet Gynaecol. 1992;99:547–553.

    Article  CAS  PubMed  Google Scholar 

  3. Goldenberg RL, Rouse DJ Prevention of premature birth. N Engl J Med. 1998;339:313–320.

    Article  CAS  PubMed  Google Scholar 

  4. Zhang J., Klebanoff MA, Roberts JM Prediction of adverse outcomes by common definitions of hypertension in pregnancy. Obstet Gynecol. 2001;97:261–267.

    CAS  PubMed  Google Scholar 

  5. Roberts JM, Bodnar LM, Lain KY, et al. Uric acid is as important as proteinuria in identifying fetal risk in women with gestational hypertension. Hypertension. 2005;46:1263–1269.

    Article  CAS  PubMed  Google Scholar 

  6. Redman CW, Sargent IL Latest advances in understanding preeclampsia. Science. 2005;308:1592–1594.

    Article  CAS  PubMed  Google Scholar 

  7. Roberts JM Objective evidence of endothelial dysfunction in preeclampsia. Am J Kidney Dis. 1999;33:992–997.

    Article  CAS  PubMed  Google Scholar 

  8. Roberts JM Endothelial dysfunction in preeclampsia. Semin Reprod Endocrinol. 1998;16:5–15.

    Article  CAS  PubMed  Google Scholar 

  9. Roberts JM Preeclampsia: not simply pregnancy-induced hypertension. Hosp Pract (Off Ed). 1995;30:25–28, 31–36.

    Google Scholar 

  10. Roberts JM, Taylor RN, Musci TJ, Rodgers GM, Hubel CA, McLaughlin MK Preeclampsia: an endothelial cell disorder. Am J Obstet Gynecol. 1989;161:1200–1204.

    Article  CAS  PubMed  Google Scholar 

  11. Chavarria ME, Lara-Gonzalez L., Gonzalez-Gleason A., Sojo I., Reyes A. Maternal plasma cellular fibronectin concentrations in normal and preeclamptic pregnancies: a longitudinal study for early prediction of preeclampsia. Am J Obstet Gynecol. 2002; 187:595–601.

    Article  CAS  PubMed  Google Scholar 

  12. Powers RW, Evans RW, Ness RB, Crombleholme WR, Roberts JM Homocysteine and cellular fibronectin are increased in preeclampsia, not transient hypertension of pregnancy. Hypertens Pregnancy. 2001;20:69–77.

    Article  CAS  PubMed  Google Scholar 

  13. Powers RW, Evans RW, Majors AK, et al. Plasma homocysteine concentration is increased in preeclampsia and is associated with evidence of endothelial activation. Am J Obstet Gynecol. 1998;179:1605–1611.

    Article  CAS  PubMed  Google Scholar 

  14. Friedman SA, de Groot CJM, Taylor RN, Heilbron DC, Roberts JM Plasma cellular fibronectin as a measure of endothelial involvement in preeclampsia and intrauterine growth retardation. Am J Obstet Gynecol. 1994;170:838–841.

    Article  CAS  PubMed  Google Scholar 

  15. Taylor RN, Crumbleholme WR, Friedman SA, Jones LA, Casal DC, Roberts JM High plasma cellular fibronectin levels correlate with biochemical and clinical features of preeclampsia but cannot be attributed to hypertension alone. Am J Obstet Gynecol. 1991;165:895–901.

    Article  CAS  PubMed  Google Scholar 

  16. Lockwood C., Peters J. Increased plasma levels of ED1+ cellular fibronectin precede the clinical signs of preeclampsia. Am J Obstet Gynecol. 1990;162:358–362.

    Article  CAS  PubMed  Google Scholar 

  17. Gifford RW, August PA, Cunningham G., et al. Report of the National High Blood Pressure Education Program Working Group on High Blood Pressure in Pregnancy. Am J Obstet Gynecol. 2000;183:S1–S22.

    Article  Google Scholar 

  18. Lind T., Godfrey KA, Otun H., Philips PR Changes in serum uric acid concentrations during normal pregnancy. Br J Obstet Gynaecol. 1984;91:128–132.

    Article  CAS  PubMed  Google Scholar 

  19. Roberts JM, Bodnar LM, Lain KY, et al. Uric acid is as important as proteinuria in identifying fetal risk in women with gestational hypertension. Hypertension. 2005;46:1263–1269.

    Article  CAS  PubMed  Google Scholar 

  20. Bodnar LM, Ness RB, Markovic N., Roberts JM The risk of preeclampsia rises with increasing prepregnancy body mass index. Ann Epidemiol. 2005;15:475–482.

    Article  PubMed  Google Scholar 

  21. Lain KY, Krohn MA, Roberts JM Second pregnancy outcomes following preeclampsia in a first pregnancy. Hypertens Pregnancy. 2005;24:159–169.

    Article  PubMed  Google Scholar 

  22. Frohlich EP Elevated fibronectin levels and preeclampsia [letter]. Am J Obstet Gynecol. 1989;160:1022–1023.

    Article  CAS  PubMed  Google Scholar 

  23. Yoshida A., Nakao S., Kobayashi M., Kobayashi H. Flow-mediated vasodilation and plasma fibronectin levels in preeclampsia. Hypertension. 2000;36:400–404.

    Article  CAS  PubMed  Google Scholar 

  24. Islami D., Shoukir Y., Dupont P., Campana A., Bischof P. Is cellular fibronectin a biological marker for pre-eclampsia? Eur J Obstet Gynecol Reprod Biol. 2001;97:40–45.

    Article  CAS  PubMed  Google Scholar 

  25. Ostlund E., Hansson LO, Bremme K. Fibronectin is a marker for organ involvement and may reflect the severity of preeclampsia. Hypertens Pregnancy. 2001;20:79–87.

    Article  CAS  PubMed  Google Scholar 

  26. Peters J., Maunder R., Woolf A., Cochrane C., Ginsberg M. Elevated plasma levels of ED1+ (“cellular”) fibronectin in patients with vascular injury. J Lab Clin Med. 1989;113: 586–597.

    CAS  PubMed  Google Scholar 

  27. Murphy-Ullrich JE, Mosher DF Fibronectin and disease processes. In: Perejda UJ, ed. Connective Tissue Disease: Molecular Pathology of the Extracellular Matrix. New York, NY: Marcel Dekker, 1986:455–473.

    Google Scholar 

  28. Austgulen R., Lien E., Vince G., Redman CW Increased maternal plasma levels of soluble adhesion molecules (ICAM-1, VCAM-1, E-selectin) in preeclampsia. Eur J Obstet Gynecol Reprod Biol. 1997;71:53–58.

    Article  CAS  PubMed  Google Scholar 

  29. Djurovic S., Schjetlein R., Wisloff F., Haugen G., Berg K. Increased levels of intercellular adhesion molecules and vascular cell adhesion molecules in pre-eclampsia. Br J Obstet Gynaecol. 1997;104:466–470.

    Article  CAS  PubMed  Google Scholar 

  30. Higgins JR, Papayianni A., Brady HR, Darling MRN, Walshe JJ Circulating vascular cell adhesion molecule-1 in pre-eclampsia, gestational hypertension, and normal pregnancy- evidence of selective dysregulation of vascular cell adhesion molecule-1 homeostasis in pre-eclampsia. Am J Obstet Gynecol. 1998;179:464–469.

    Article  CAS  PubMed  Google Scholar 

  31. Krauss T., Emons G., Kuhn W., Augustin HG Predictive value of routine circulating soluble endothelial cell adhesion molecule measurements during pregnancy. Clin Chem. 2002;48: 1418–1425.

    CAS  PubMed  Google Scholar 

  32. Kim S.-Y., Ryu H.-M, Yang JH, et al. Maternal serum levels of VCAM-1, ICAM-1 and E-selectin in preeclampsia. J Korean Med Sci. 2004;19:688–692.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  33. Vadachkoria S., Sanchez SE, Qiu C., Muy-Rivera M., Malinow MR, Williams MA Hyperhomocyst(e)inemia and elevated soluble vascular cell adhesion molecule-1 concentrations are associated with an increased risk of preeclampsia. Gynecol Obstet Invest. 2004;58:133–139.

    Article  CAS  PubMed  Google Scholar 

  34. Taylor RN, Crombleholme WR, Friedman SA, Jones LA, Casal DC, Roberts JM High plasma cellular fibronectin levels correlate with biochemical and clinical features of preeclampsia but cannot be attributed to hypertension alone. Am J Obstet Gynecol. 1991;165:895–901.

    Article  CAS  PubMed  Google Scholar 

  35. Friedman SA, de Groot CJ, Taylor RN, Golditch BD, Roberts JM Plasma cellular fibronectin as a measure of endothelial involvement in preeclampsia and intrauterine growth retardation. Am J Obstet Gynecol. 1994;170:838–841.

    Article  CAS  PubMed  Google Scholar 

  36. Paarlberg KM, de Jong CL, van Geijn HP, van Kamp GJ, Heinen AG, Dekker GA Total plasma fibronectin as a marker of pregnancy-induced hypertensive disorders: a longitudinal study. Obstet Gynecol. 1998;91:383–388.

    Article  CAS  PubMed  Google Scholar 

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Author notes

  1. RWP and JMC contributed equally to this work.

Authors and Affiliations

  1. Magee-Womens Research Institute, 204 Craft Ave, Room 620, Pittsburgh, Pennsylvania, 15213, USA

    Robert W. Powers PhD, Janet M. Catov PhD, Lisa M. Bodnar PhD, Marcia J. Gallaher BS & James M. Roberts MD

  2. Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA

    Robert W. Powers PhD, Lisa M. Bodnar PhD & James M. Roberts MD

  3. Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania, USA

    Janet M. Catov PhD, Lisa M. Bodnar PhD & James M. Roberts MD

  4. Department of Obstetrics and Gynecology, University of Kentucky, Lexington, USA

    Kristine Y. Lain MD

Authors
  1. Robert W. Powers PhD
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  2. Janet M. Catov PhD
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  3. Lisa M. Bodnar PhD
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  4. Marcia J. Gallaher BS
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  5. Kristine Y. Lain MD
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  6. James M. Roberts MD
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Corresponding author

Correspondence to Robert W. Powers PhD.

Additional information

This project was supported by the National Institutes of Health grant P01-HD30367 and by funds received from the National Institutes of Health/National Center for Research Resources/General Clinic Research Centers grant M01-RR00056.Presented at the 15th World Congress of the International Society for Study of Hypertension in Pregnancy, Lisbon, Portugal, July 2–5, 2006.

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Powers, R.W., Catov, J.M., Bodnar, L.M. et al. Evidence of Endothelial Dysfunction in Preeclampsia and Risk of Adverse Pregnancy Outcome. Reprod. Sci. 15, 374–381 (2008). https://doi.org/10.1177/1933719107311780

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  • DOI: https://doi.org/10.1177/1933719107311780

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