Maternal and umbilical homocysteine in preeclampsia

Background and purpose: Were to assess the association between homocysteine levels and development of preeclampsia, to determine homocysteine levels in fetal circulation, to differentiate homocysteine levels in mild and severe preeclampsia and to compare homocysteine levels in pregnant women with preeclampsia with homocysteine levels measured in the same group of women six months after delivery. Material and methods: The study included 55 pregnant women with mild or severe preeclampsia (hypertensia with proteinuria), while control group of 50 healthy pregnant women. Maternal and umbilical blood homocysteine levels were determined by the fluorescence polarization immunoassay. Shapiro-Wilks, Mann-Whitney and Wilcoxon statistical tests performed for statistical analysis. Results: In women with preeclampsia, the mean homocysteine level was by 0.744 μmol/L higher than in control women; with mild preeclampsia, the level was by 2.752 μmol/L lower as compared to the women with severe preeclampsia (p < 0.0001). In women with preeclampsia, the mean umbilical blood homocysteine level was by 0.268 μmol/L lower than the respective level measured in control group (p < 0,0001). In women with preeclampsia, the mean homocysteine level was by 0.878 μmol/L lower in the same group of women six months after delivery (p < 0.0001). Conclusion: Homocysteine are lower in preeclamptic women six months after delivery. The neonates born to mothers with preeclampsia are not at a higher exposure to homocysteine

Protein S and protein C in preeclamptic pregnant women

Background and purpose: Deficits of protein C and protein S are associated with an increased incidence of thrombotic disorders. The aim of the present study was to determine the levels of the mentioned natural coagulation inhibitors in women with preeclampsia and in a 6-months followup period after delivery.Materials and methods: This case-control clinical study included 55 pregnant women (cases) with preeclampsia and 50 healthy normotensive pregnant women (controls) in tertiary perinatal centre. Protein C levels were determined photometrically using a chromogen substrate, and protein S levels were determined using the clot method and optic detection.Results: There were no significant differences in protein C and protein S levels between women with preeclampsia and healthy pregnant women; however, six months after delivery protein S levels were significantly lower in women with preeclampsia as compared to healthy peers, whereas protein C levels did not differ significantly.Conclusion: Possible long-term cardiovascular morbidity should be assessed in preeclampsia women

Perinatalni epidemiološki čimbenici rizika za preeklampsiju

In the present study, the impact of the potential perinatal epidemiological factors on preeclampsia development was assessed. This clinical study included 55 pregnant women with preeclampsia and control group of 50 healthy pregnant women. Positive family history of cardiovascular disease, diabetes mellitus or thromboembolic disease was recorded in 50% of women with preeclampsia versus 28% of control group women. Positive personal history of this disease was recorded in 15% of women with preeclampsia, whereas all control group women had negative personal history of preeclampsia. Dietary habits, i.e. the intake of meat and meat products, fruit and vegetables, coffee and alcohol drinks were similar in the two groups, without statistically significant differences. The women with preeclampsia and control women reported comparable habits; there was no difference in the consumption of meat, fruit, vegetables, coffee and alcohol, smoking, use of folate and oral hormonal contraception before pregnancy, or in physical activity as the potential risk factors for preeclampsia in current pregnancy. However, personal and family history of vascular disease proved to be significant risk factors for the occurrence of preeclampsia, emphasizing the need of lifestyle and dietary modifications with healthy dietary habits, while avoiding adverse habits in pregnancy.U ovom istraživanju ispitan je utjecaj potencijalnih perinatalnih epidemioloških čimbenika na razvoj preeklampsije. U kliničko istraživanje je bilo uključeno 55 trudnica s preeklampsijom i kontrolna skupina od 50 zdravih trudnica. Pozitivna obiteljska anamneza kardiovaskularnih bolesti, šećerne bolesti ili tromboembolija zabilježena je u 50% žena s preeklampsijom u odnosu na 28% u kontrolnoj skupini trudnica. Pozitivna anamneza prethodne preeklampsije zabilježena je u 15% žena u skupini s aktualnom preeklampsijom, dok su sve žene kontrolne skupine imale negativnu anamnezu preeklampsije. Prehrambene navike, odnosno uzimanje mesa i mesnih proizvoda, voća i povrća, kave i alkoholnih pića bile su slične u objema skupinama, bez statistički značajne razlike, kao i primjena oralne hormonske kontracepcije i fizičke aktivnosti prije trudnoće. Međutim, osobna i obiteljska anamneza krvožilnih bolesti pokazale su se značajnim čimbenicima rizika za pojavu preeklampsije, naglašavajući potrebu promjene načina života uz zdrave prehrambene navike i izbjegavanje štetnih navika u trudnoći

Kardiovaskularni rizik kod žena s preeklampsijom

In this study, possible biochemical and functional cardiovascular markers were assessed in women with preeclampsia. Fifty-five pregnant women with manifest moderate (mild) preeclampsia (PE) and fifty healthy women as a control group were included in this prospective study. Laboratory tests including lipid panel, C-reactive protein (CRP), and homocysteine levels as biohumoral markers of atherogenesis, as well as ergometry and the main cardiovascular risk factor markers were performed in all women during pregnancy and six months after delivery. In our study, cholesterol and LDL levels in the PE group did not differ from those in the control group. Triglyceride levels in the PE group were higher than the corresponding values found in normal pregnancies, while HDL levels were significantly lower in the PE group than in the normal pregnancy group (p<0.001). The values of total cholesterol, LDL, HDL, and triglycerides in the PE group were higher compared to those in the same group six months after delivery (p<0.001). The effect of PE as an inflammatory disease could be confirmed to a certain extent by elevated CRP levels (p<0.001). A very high percentage of negative exercise stress tests indicated a good cardiovascular response to the current PE in the otherwise healthy pregestational women. It could be concluded that the development of possible cardiovascular comorbidities in preeclamptic pregnant women is a long process, but also due to etiologic factors of coexistent metabolic disorders such as dyslipidemia, as well as elevated inflammatory markers and homocysteine, PE can be considered even an early predictor of cardiovascular disease.U ovom članku prikazani su mogući biokemijski i funkcionalni kardiovaskularni pokazatelji kod žena s preeklampsijom. U ovu prospektivnu studiju uključeno je pedeset i pet trudnica s umjerenom (blagom) preeklampsijom (PE) te pedeset zdravih žena u kontrolnoj skupini inicijalno tijekom trudnoće te šest mjeseci nakon porođaja. Laboratorijska analiza je uključivala određivanje lipidograma, C-reaktivnog proteina (CRP) i razine homocisteina kao biohumoralnog pokazatelja aterogeneze, kao i test opterećenja na pokretnom sagu uz izdvajanje osnovnih poznatih kardiovaskularnih čimbenika rizika. U našoj studiji razina ukupnog kolesterola i LDL kolesterola u skupini s PE nije se razlikovala od onih u kontrolnoj skupini. Razine triglicerida u skupini s PE bile su više od odgovarajućih vrijednosti u normalnim trudnoćama, dok su razine HDL u skupini s PE bile značajno niže nego u kontrolnoj skupini (p<0,001). Vrijednosti ukupnog kolesterola, LDL-a, HDL-a i triglicerida u skupini s PE bile su značajno više u trudnoći u usporedbi s onima u istoj skupini šest mjeseci nakon porođaja (p<0,001). Učinak PE kao upalne bolesti može se u određenoj mjeri potvrditi povišenim razinama CRP-a (p<0,001). Vrlo visok postotak negativnih testova na testu opterećenja pokazao je dobru kardiovaskularnu funkcionalnu sposobnost naspram PE u inače pregestacijski zdravih žena. Može se zaključiti da je razvoj mogućih kardiovaskularnih supostojećih bolesti kod trudnica s PE dug proces, ali svakako zbog etiologije metaboličkih poremećaja kao što je dislipidemija, kao i povišenih upalnih pokazatelja i homocisteina, ujedno i rani prediktor kardiovaskularnih bolesti

Pregestional obesity - risk factor for preeclampsia

Cilj istraživanja je proučiti pregestacijsku i gestacijsku debljinu kao čimbenika rizika nastanka preeklampsije koristeći indeks tjelesne mase (ITM). Klinička studija uključila je 55 trudnica s preeklampsijom i 50 trudnica bez preeklampsije s mjerenjem pregestacijskog i gestacijskog ITM. Srednja vrijednost tjelesne težine u preeklamptičnih trudnica iznosila je 88,195 kg, a u kontrolnoj skupini 77,030 kg. Kod žena s preeklampsijom, srednja vrijednost gestacijske debljine je bila 15,709 kg, dok je u kontrolnoj skupini bila 14,760 kg, gdje testirana vrijednost nije pokazala statističku značajnost između žena s preeklampsijom u odnosu na kontrolnu skupinu. Srednja vrijednost ITM u preeklamptičnih trudnica iznosi 32,235 kg/m2, a u kontrolnoj skupini ITM je iznosila 27,766 kg/m2, što je statistički značajno. U ovom istraživanju, dokazan je značajno viši prekoncepcijski ITM u preeklamptičnih trudnica, nego u skupini zdravih trudnica, što sugerira povišeni pregestacijski ITM čimbenikom rizika nastanka preeklamspije.Aim: The aim of the study was to determine pregestational and gestational obesity as risk factors for the occurrence of preeclampsia using body mass index (BMI), as the first research in the East Croatian region. Material and methods: This clinical study included 55 pregnant women with preeclampsia and a control group of 50 pregnant women without preeclampsia with measurement pregestational and gestational weight and body mass index. Results: The mean body weight of preeclampsia women was 88.195 kg; by median, the mean body weight of control women was 77.030 kg. In women with preeclampsia, the mean gestational weight gain was 15.709 kg; in the control group, the mean gestational weight gain was 14.760 kg, whereas testing yielded no statistically significant differences in the mean weight gain between the preeclampsia women with the control group. The mean BMI in the group of women with preeclampsia was 32.235 kg/m2; in the control group, the mean BMI was 27.766 kg/m2. T-test yielded a statistically significant difference in the mean BMI between the preeclampsia group and control group of women with a normal course of pregnancy. Conclusion: In our study, we found that women with preeclampsia had significantly higher BMI values at conception as compared to the group of pregnant women with a normal course of pregnancy, suggesting the increased pregestational BMI to be a risk factor for developing preeclampsia in pregnancy

Intima media thickness in women with preeclampsia

Cilj istraživanja: Procijeniti debljinu intima-medije, zajedničke karotidne arterije u žena šest mjeseci nakon trudnoće i porođaja kompliciranih s preeklampsijom u komparaciji sa zdravim trudnicama. Materijal i metode: Klinička studija uključila je 55 žena šest mjeseci nakon trudnoće i porođaja kompliciranih preeklampsijom, bez aktualne hipertenzije, medikacije i komorbiditeta i kontrolnu skupinu od 50 zdravih žena, šest mjeseci nakon porođaja, bez perinatalnih komplikacija. Debljina intima-medije mjerena je u donjem segmentu zajedničke karotidne arterije na tipičnom mjestu 1-2 centimetra od bifurkacije uporabljujući B-mode. Rezultati: Srednja vrijednost debljina intima-medije u bolesnica koje su imale preeklampsiju iznosila je 0,419 ± 0,29 mm, dok je u kontrolnoj skupini iznosila 0,412 ± 0,43 mm, što je statistički neznačajno (p > 0,0001). Zaključak: Nisu pronađene rane aterosklerotske promjene, mjereći debljinu intima-medije šest mjeseci nakon trudnoće komplicirane preeklamspijom, no zbog poznate dugotrajne ateropatogeneze, potrebne su dugoročnije studije, što je zaključak istraživanja.Aim: To investigate the difference in intima-media thickness of common carotid artery in women 6 months after pregnancy and delivery complicated by preeclampsia as compared to the age-matched control. Material and methods: The clinical study enrolled 55 women six months after pregnancy and delivery complicated by preeclampsia without actual hypertension, medication and comorbidity and control group of 50 healthy women six months after delivery without perinatal complications. Intima-media thickness was measured on the lower segment of both common carotid arteries on the exact site of 1 to 2 centimetres proximal to the bifurcation using optimal B-mode settings. Results: The mean value of the intima-media thickness in patients who had preeclampsia 6 months prior to the measurement was 0.419 ± 0,29mm while in the control group the mean value was 0.412 ± 0.43 mm. The difference in intima-media thickness was shown to be insignificant (p > 0.0001). Conclusion: It was not possible to detect early atherosclerotic changes by measuring intima-media thickness six months after pregnancy with preeclampsia. Due to the long atheropathogenesis process, long term follow-up is needed

Perinatalni epidemiološki čimbenici rizika za preeklampsiju

In the present study, the impact of the potential perinatal epidemiological factors on preeclampsia development was assessed. This clinical study included 55 pregnant women with preeclampsia and control group of 50 healthy pregnant women. Positive family history of cardiovascular disease, diabetes mellitus or thromboembolic disease was recorded in 50% of women with preeclampsia versus 28% of control group women. Positive personal history of this disease was recorded in 15% of women with preeclampsia, whereas all control group women had negative personal history of preeclampsia. Dietary habits, i.e. the intake of meat and meat products, fruit and vegetables, coffee and alcohol drinks were similar in the two groups, without statistically significant differences. The women with preeclampsia and control women reported comparable habits; there was no difference in the consumption of meat, fruit, vegetables, coffee and alcohol, smoking, use of folate and oral hormonal contraception before pregnancy, or in physical activity as the potential risk factors for preeclampsia in current pregnancy. However, personal and family history of vascular disease proved to be significant risk factors for the occurrence of preeclampsia, emphasizing the need of lifestyle and dietary modifications with healthy dietary habits, while avoiding adverse habits in pregnancy.U ovom istraživanju ispitan je utjecaj potencijalnih perinatalnih epidemioloških čimbenika na razvoj preeklampsije. U kliničko istraživanje je bilo uključeno 55 trudnica s preeklampsijom i kontrolna skupina od 50 zdravih trudnica. Pozitivna obiteljska anamneza kardiovaskularnih bolesti, šećerne bolesti ili tromboembolija zabilježena je u 50% žena s preeklampsijom u odnosu na 28% u kontrolnoj skupini trudnica. Pozitivna anamneza prethodne preeklampsije zabilježena je u 15% žena u skupini s aktualnom preeklampsijom, dok su sve žene kontrolne skupine imale negativnu anamnezu preeklampsije. Prehrambene navike, odnosno uzimanje mesa i mesnih proizvoda, voća i povrća, kave i alkoholnih pića bile su slične u objema skupinama, bez statistički značajne razlike, kao i primjena oralne hormonske kontracepcije i fizičke aktivnosti prije trudnoće. Međutim, osobna i obiteljska anamneza krvožilnih bolesti pokazale su se značajnim čimbenicima rizika za pojavu preeklampsije, naglašavajući potrebu promjene načina života uz zdrave prehrambene navike i izbjegavanje štetnih navika u trudnoći

Perinatal Epidemiological Risk Factors for Preeclampsia

In the present study, the impact of the potential perinatal epidemiological factors on preeclampsia development was assessed. This clinical study included 55 pregnant women with preeclampsia and control group of 50 healthy pregnant women. Positive family history of cardiovascular disease, diabetes mellitus or thromboembolic disease was recorded in 50% of women with preeclampsia versus 28% of control group women. Positive personal history of this disease was recorded in 15% of women with preeclampsia, whereas all control group women had negative personal history of preeclampsia. Dietary habits, i.e. the intake of meat and meat products, fruit and vegetables, coffee and alcohol drinks were similar in the two groups, without statistically significant differences. The women with preeclampsia and control women reported comparable habits; there was no difference in the consumption of meat, fruit, vegetables, coffee and alcohol, smoking, use of folate and oral hormonal contraception before pregnancy, or in physical activity as the potential risk factors for preeclampsia in current pregnancy. However, personal and family history of vascular disease proved to be significant risk factors for the occurrence of preeclampsia, emphasizing the need of lifestyle and dietary modifications with healthy dietary habits, while avoiding adverse habits in pregnancy