Family history of pre-eclampsia and cardiovascular disease as risk factors for pre-eclampsia: the GenPE case-control study

Serrano, Norma C.; Quintero-Lesmes, Doris Cristina; Dudbridge, Frank; Leon, Lydia J.; Hingorani, Aroon D.; Williams, David; Casas, Juan P.

doi:10.1080/10641955.2019.1704003

Cited by 16 publications

(10 citation statements)

References 28 publications

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“…67 There has been a desire to investigate genetic causes of preeclampsia. Observations that led to a suggestion of a genetic component to preeclampsia are as follows: (1) studies that found an increased risk of recurrence of preeclampsia in subsequent pregnancies, 68e70 (2) studies that observed an increased risk in first-degree relatives of women with preeclampsia, 71,72 and (3) familial studies that found that a family history of hypertension and cardiovascular disease is associated with the occurrence of preeclampsia. 73,74 Preeclampsia manifests as complex phenotypes, resulting from both maternal and fetal genetic features.…”

Section: Expert Reviewmentioning

confidence: 99%

Does race or ethnicity play a role in the origin, pathophysiology, and outcomes of preeclampsia? An expert review of the literature

Johnson

Louis

2022

American Journal of Obstetrics and Gynecology

102

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Section: Expert Reviewmentioning

confidence: 99%

Does race or ethnicity play a role in the origin, pathophysiology, and outcomes of preeclampsia? An expert review of the literature

Johnson

Louis

2022

American Journal of Obstetrics and Gynecology

102

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“…Importantly, maternal hypertension predicted PE more strongly than paternal hypertension. These results may reflect the influence of genetic factors reported in the literature [9,45,46].…”

Section: Discussionmentioning

confidence: 55%

Pre-Pregnancy Obesity vs. Other Risk Factors in Probability Models of Preeclampsia and Gestational Hypertension

Lewandowska

Więckowska

Sajdak³

et al. 2020

Nutrients

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In the face of the obesity epidemic around the world, attention should be focused on the role of maternal obesity in the development of pregnancy. The purpose of this analysis was to evaluate the prediction of preeclampsia (PE) and isolated gestational hypertension (GH) for a number of maternal factors, in order to investigate the importance of pre-pregnancy obesity (body mass index, BMI ≥ 30 kg/m2), compared to other risk factors (e.g., prior PE, pregnancy weight gain (GWG), infertility treatment, interpregnancy interval, family history, the lack of vitamin supplementation, urogenital infection, and socioeconomic factors). In total, 912 women without chronic diseases were examined in a Polish prospective cohort of women with a single pregnancy (recruited in 2015–2016). Separate analyses were performed for the women who developed GH (n = 113) vs. 775 women who remained normotensive, as well as for those who developed PE (n = 24) vs. 775 controls. The probability of each disease was assessed for the base prediction model (age + primiparity) and for the model extended by one (test) variable, using logistic regression. Three measures were used to assess the prediction: area under curve (AUC) of the base and extended model, integrated discrimination improvement (IDI) (the index shows the difference between the value of the mean change in the predicted probability between the group of sick and healthy women when a new factor is added to the model), and net reclassification improvement (NRI) (the index focuses on the reclassification table describing the number of women in whom an upward or downward shift in the disease probability value occurred after a new factor had been added, including results for healthy and sick women). In the GH prediction, AUC increased most strongly when we added BMI (kg/m2) as a continuous variable (AUC = 0.716, p < 0.001) to the base model. The highest IDI index was obtained for prior GH/PE (IDI = 0.068, p < 0.001). The addition of BMI as a continuous variable or BMI ≥ 25 kg/m2 improved the classification for healthy and sick women the most (NRI = 0.571, p < 0.001). In the PE prediction, AUC increased most strongly when we added BMI categories (AUC = 0.726, p < 0.001) to the base model. The highest IDI index was obtained for prior GH/PE (IDI = 0.050, p = 0.080). The addition of BMI categories improved the classification for healthy and sick women the most (NRI = 0.688; p = 0.001). After summing up the results of three indexes, the probability of hypertension in pregnancy was most strongly improved by BMI, including BMI ≥ 25 kg/m2 for the GH prediction, and BMI ≥ 30 kg/m2 for the PE prediction. Main conclusions: Pre-pregnancy BMI was the most likely factor to increase the probability of developing hypertension in pregnancy, compared to other risk factors. Hierarchies of PE and GH risk factors may suggest different (or common) mechanisms of their development.

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“…The discrepancies between the studies could be attributed to differences in clinical methodology, sizes of the studied groups, risk of the studied populations, the numbers of early-onset preeclampsia (PE) (<34th weeks) and late-onset PE cases, ethnic differences, as well as differences in the definitions of ‘family hypertension’ or ‘hypertension in pregnancy’ and the degree of adjustment [ 4 , 8 , 11 , 12 , 13 , 21 ].…”

Section: Discussionmentioning

confidence: 99%

“…A family history of hypertension is also considered [ 2 , 7 ]. Family history of hypertension (which is already available before pregnancy) may predispose pregnant women to develop PIH, providing information about the potential influence of genetic and environmental factors [ 2 , 4 , 7 , 8 , 9 , 10 ].…”

Section: Introductionmentioning

confidence: 99%

“…However, the role of the family history of hypertension as an independent risk factor of pregnancy-induced hypertension (PIH) has not been clearly established [ 4 , 8 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 ]. Only the Society of Obstetricians and Gynaecologists of Canada (SOGC) 2014 guidelines list a family history of early cardiovascular disease among the risk factors for preeclampsia (PE) that determine the use of aspirin prophylaxis, in contrast to the guidelines of other scientific societies [ 11 ].…”

Section: Introductionmentioning

confidence: 99%

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The Association of Familial Hypertension and Risk of Gestational Hypertension and Preeclampsia

Lewandowska

2021

IJERPH

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It has not been established how history of hypertension in the father or mother of pregnant women, combined with obesity or smoking, affects the risk of main forms of pregnancy-induced hypertension. A cohort of 912 pregnant women, recruited in the first trimester, was assessed; 113 (12.4%) women developed gestational hypertension (GH), 24 (2.6%) developed preeclampsia (PE) and 775 women remained normotensive (a control group). Multiple logistic regression was used to calculate adjusted odds ratios (AOR) (and 95% confidence intervals) of GH and PE for chronic hypertension in the father or mother of pregnant women. Some differences were discovered. (1) Paternal hypertension (vs. absence of hypertension in the family) was an independent risk factor for GH (AOR-a = 1.98 (1.2–3.28), p = 0.008). This odds ratio increased in pregnant women who smoked in the first trimester (AOR-a = 4.71 (1.01–21.96); p = 0.048) or smoked before pregnancy (AOR-a = 3.15 (1.16–8.54); p = 0.024), or had pre-pregnancy overweight (AOR-a = 2.67 (1.02–7.02); p = 0.046). (2) Maternal hypertension (vs. absence of hypertension in the family) was an independent risk factor for preeclampsia (PE) (AOR-a = 3.26 (1.3–8.16); p = 0.012). This odds ratio increased in the obese women (AOR-a = 6.51 (1.05–40.25); p = 0.044) and (paradoxically) in women who had never smoked (AOR-a = 5.31 (1.91–14.8); p = 0.001). Conclusions: Chronic hypertension in the father or mother affected the risk of preeclampsia and gestational hypertension in different ways. Modifiable factors (overweight/obesity and smoking) may exacerbate the relationships in question, however, paradoxically, beneficial effects of smoking for preeclampsia risk are also possible. Importantly, paternal and maternal hypertension were not independent risk factors for GH/PE in a subgroup of women with normal body mass index (BMI).

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Family history of pre-eclampsia and cardiovascular disease as risk factors for pre-eclampsia: the GenPE case-control study

Cited by 16 publications

References 28 publications

Does race or ethnicity play a role in the origin, pathophysiology, and outcomes of preeclampsia? An expert review of the literature

Does race or ethnicity play a role in the origin, pathophysiology, and outcomes of preeclampsia? An expert review of the literature

Pre-Pregnancy Obesity vs. Other Risk Factors in Probability Models of Preeclampsia and Gestational Hypertension

The Association of Familial Hypertension and Risk of Gestational Hypertension and Preeclampsia

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