Maternal Glomerular Filtration Rate in Pregnancy and Fetal Size

Morken, Nils‐Halvdan; Travlos, Gregory S.; Wilson, Ralph E.; Eggesbø, Merete; Longnecker, Matthew P.

doi:10.1371/journal.pone.0101897

Cited by 47 publications

(51 citation statements)

References 31 publications

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“…In fact earlier studies done in the 1970’s by Gibson et al showed that the lack of rise in GFR during early pregnancy is associated with women that have increased risks of unexplained stillbirths, abortions, or small for gestational age babies 43 . The same trends have been observed in more recent studies where there is a strong positive correlation between maternal GFR and fetal size 44 . Furthermore, the lack of rise in GFR during pregnancy can increase the levels of circulating uric acid during pregnancy and damage the glomerular filtration barrier, leading to an increase in proteinuria and glomerular damage 45 .…”

Section: Discussionsupporting

confidence: 87%

Agonistic Autoantibodies to the Angiotensin II Type 1 Receptor Enhance Angiotensin II–Induced Renal Vascular Sensitivity and Reduce Renal Function During Pregnancy

et al. 2016

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Preeclampsia is a multisystemic disorder that is characterized by new-onset hypertension that usually occurs in the third trimester of pregnancy. 1,2 It is estimated that between 3% and 5% of pregnant women in the United States each year have preeclampsia. Preeclampsia is the leading cause of preterm birth, morbidity, and mortality for the mother and the fetus. 1,2Women with preeclampsia have elevated levels of the angiotensin II type 1 receptor autoantibodies (AT1-AA), oxidative stress, reduced renal function, and increased angiotensin II (ANG II) sensitivity.3-8 AT1-AAs in preeclampsia bind with a high affinity to the 7 amino acid sequence on the second extracellular loop of the AT1 receptor, in which it activates the AT1 receptor, increases intracellular calcium levels, and stimulates activation of intracellular mean arterial pressure/ERK kinase and tumor necrosis factor-α pathways similar to ANG II. [9][10][11][12][13] Several studies from our laboratory and others have demonstrated the important role of AT1-AAs in the pathophysiology of preeclampsia. In vitro studies with vascular smooth muscle and trophoblast cells demonstrate increased tissue factor VII and tissue factor activity, reactive oxygen species (ROS), NADPH oxidase components, and activation of NFκβ when incubated with AT1-AAs.13-15 Furthermore, human umbilical vein endothelial cells incubated for 6 hours with the AT1-AAs drastically increased endothelin-1 protein expression. 16 In vivo studies, in which isolated human and rodent AT1-AAs administered to rats during pregnancy, increased blood pressure, oxidative stress, renal artery resistant index, and several circulating factors associated with preeclampsia, such as soluble fms-like tyrosine kinase 1, sEng, endothelin-1, and endothelial microparticles. 7,[16][17][18][19][20][21][22] Thus, all these studies taken together confirm the critical role of AT1-AAs in causing many of the common characteristics of preeclampsia observed in women. 7,[16][17][18][19][20][21][22] Another characteristic shared by women with preeclampsia is increased sensitivity to ANG II, demonstrated years ago by Gant et al. 8 In Gant et al's 8 studies, young women between ages 13 and 17 years, with majority being black American women, were infused with various doses of ANG II until their diastolic blood pressure increased by 20 mm Hg. 11 In this study, they found that women destined to become preeclamptic displayed an increase in blood pressure at lower concentrations of ANG II versus those who had a normal pregnancy. From this early study, it was established that women with preeclampsia have increased sensitivity to ANG II from as early as 22 weeks of gestation until term. 11Abstract-Preeclamptic women produce agonistic autoantibodies to the angiotensin II type 1 receptor (AT1-AA) and exhibit increased blood pressure (mean arterial pressure), vascular sensitivity to angiotensin II (ANG II), and display a decrease in renal function. The objective of this study was to examine the renal hemodynamic changes during pregnancy i...

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Section: Discussionsupporting

confidence: 87%

Agonistic Autoantibodies to the Angiotensin II Type 1 Receptor Enhance Angiotensin II–Induced Renal Vascular Sensitivity and Reduce Renal Function During Pregnancy

et al. 2016

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“…GFR describes the flow rate of filtered fluid through the kidney, and we postulate that higher GFR leads to more excretion of PFASs and thereby lower serum levels of PFASs. Because studies have indicated a possible association between GFR and infant birth weight [46], GFR might be considered a potential confounder in epidemiologic studies of PFASs and fetal growth. In fact, a recent study that examined the impact of GFR on associations between PFASs and birth weight, suggested that associations were largely attenuated due to confounding by GFR [47].…”

Section: Discussionmentioning

confidence: 99%

Factors Associated with Maternal Serum Levels of Perfluoroalkyl Substances and Organochlorines: A Descriptive Study of Parous Women in Norway and Sweden

et al. 2016

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IntroductionPerfluoroalkyl substances (PFASs) and organochlorines (OCs) are ubiquitous and persistent in the environment and proposed endocrine disrupting chemicals (EDCs). They can be transferred across the placenta during pregnancy, and studies suggest that the prenatal period may be particularly sensitive for influences on fetal growth and development. Several studies have investigated socio-demographic and pregnancy related factors associated with maternal serum PFAS and OC levels, but few studies have been conducted in time periods with increasing emissions of PFASs and recent emissions of OCs.MethodsSerum from 424 pregnant women participating in the NICHD Scandinavian Successive Small-for-gestational Age (SGA) births study was collected in 1986–1988, and analyses of two PFASs and six OCs were conducted. Associations between EDCs and geographic, time dependent, socio-demographic and pregnancy related variables were evaluated by using multivariable linear regression models.ResultsPrevious breastfeeding duration, time since last breastfeeding period, sampling date and country of residence were important factors associated with serum levels of PFOS and PFOA. Smoking status and pre-pregnancy BMI were negatively associated with PFOS, and maternal height was borderline negatively associated with PFOS and PFOA. Glomerular filtration rate (GFR) was negatively associated with PFOS in a sub-sample. Maternal serum levels of OCs were positively associated with maternal age, and negatively associated with previous breastfeeding duration and sampling date. Smoking had a consistently negative association with PCB 118 in a dose-dependent manner. Education level, pre-pregnancy BMI and alcohol consumption varied in importance according to the compound under study.ConclusionsSeveral maternal factors, including potentially modifiable factors, markers of pregnancy physiology and factors also related to perinatal outcomes were associated with EDC levels. Results from this study are relevant to populations with still high PFAS and OC levels, i.e. developing countries. Moreover, we can use this knowledge about associated factors on emerging EDCs with similar properties.

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“…Maternal glomerular filtration rate (GFR) was calculated for each woman in each pregnancy, based on the formula of Cockroft-Gault (GFR= (140–age) × weight(kg) × 0.85/(72 × serum creatinine (mg/dl)) (Morken et al, 2014). The average GFR of the two pregnancies was used in the models described below.…”

Section: Methodsmentioning

confidence: 99%

“…By comparing maternal blood, cord blood, and breast milk samples studies have shown that PFASs can cross the placenta and partition into milk; hence pregnancy and breastfeeding are additional elimination pathways for women (Fromme et al, 2010; Glynn et al, 2012; Gutzkow et al, 2012). PFOS and PFOA levels are lower in pregnant women than non-pregnant women and the levels decrease across trimesters, suggesting that trans-placental transfer starts from early gestation; other physiological changes during pregnancy also contribute to this trend (Jain 2013; Javins et al, 2013; Morken et al, 2014). …”

Section: Introductionmentioning

confidence: 99%

Reliability of perfluoroalkyl substances in plasma of 100 women in two consecutive pregnancies

Papadopoulou

Haug

Sabaredzovic

et al. 2015

Environmental Research

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The potential toxicity of background exposure to perfluoroalkyl substances (PFASs) is currently under active investigation. Such investigations typically rely on a single measure of PFAS concentration, yet the longer-term reliability of a single measure has not been well characterized, especially among reproductive-aged women. Our aim was to investigate the association between PFAS plasma concentrations of 100 women in two consecutive pregnancies and explore changes in plasma concentration related to reproductive factors. The women in our study were enrolled in the Norwegian Mother and Child Cohort Study (MoBa) from 2003 to 2009. About half of them breastfed exclusively for 6 months and the rest of the participants did not breastfeed between the two consecutive pregnancies (median time between pregnancies: 18 months). Maternal blood was collected at mid-pregnancy and plasma was analyzed for 10 PFASs. Statistical analyses were restricted to 6 PFASs that were quantifiable in more than 80% of the samples. We estimated the correlation between repeated PFAS measurements, the percentage change between pregnancies and the effect of several reproductive factors in multivariate linear regression models of PFAS concentration in the second pregnancy. The Pearson correlation coefficient between repeated PFAS measurements was, for perfluorooctane sulfonate (PFOS), 0.80; perfluorooctanoate (PFOA), 0.50; perfluorohexane sulfonate (PFHxS), 0.74; perfluorononanoate (PFNA), 0.39; perfluoroundecanoate (PFUnDA), 0.71; and perfluorodecanoate (PFDA), 0.60. Adjustment for maternal age, delivery year, and time and breastfeeding between pregnancies did not substantially affect the observed correlations. We found 44-47% median reductions in the concentrations of PFOS, PFOA and PFHxS between pregnancies, while the change in concentrations between pregnancies was smaller and more variable for PFNA, PFUnDA and PFDA. The variation in plasma concentrations in the second pregnancy was mainly accounted for by the concentration in the first pregnancy; for PFOS, PFOA, and PFNA, breastfeeding also accounted for a substantial proportion. In conclusion, we found the reliability of PFAS measurements in maternal plasma to be moderate to high, and in these data, several factors, especially breastfeeding, were related to plasma concentrations.

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Maternal Glomerular Filtration Rate in Pregnancy and Fetal Size

Cited by 47 publications

References 31 publications

Agonistic Autoantibodies to the Angiotensin II Type 1 Receptor Enhance Angiotensin II–Induced Renal Vascular Sensitivity and Reduce Renal Function During Pregnancy

Agonistic Autoantibodies to the Angiotensin II Type 1 Receptor Enhance Angiotensin II–Induced Renal Vascular Sensitivity and Reduce Renal Function During Pregnancy

Factors Associated with Maternal Serum Levels of Perfluoroalkyl Substances and Organochlorines: A Descriptive Study of Parous Women in Norway and Sweden

Reliability of perfluoroalkyl substances in plasma of 100 women in two consecutive pregnancies

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