Is COVID-19 disease a risk factor for preeclampsia? Should aspirin be considered for prophylaxis of preeclampsia in these patients?

Hantoushzadeh, Sedigheh; Saleh, Maasoumeh; Nouri, Behnaz; Panahi, Zahra

doi:10.1016/j.preghy.2021.11.001

Cited by 3 publications

(3 citation statements)

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“…Some authors suggest that COVID-19 during gestation is a risk factor for development of PE/HELLP syndrome [15] or a cause of PE [16] . Other authors have noted the similarity between their pathophysiologies [4] , [12] , [14] , such as endothelial dysfunction [8] , intravascular inflammation, proteinuria [17] , high blood pressure, changes in the complement system18 and activation of the coagulation cascade in more severe forms of COVID-19.…”

Section: Introductionmentioning

confidence: 99%

“…Other authors have noted the similarity between their pathophysiologies [4] , [12] , [14] , such as endothelial dysfunction [8] , intravascular inflammation, proteinuria [17] , high blood pressure, changes in the complement system18 and activation of the coagulation cascade in more severe forms of COVID-19. Acetylsalicylic acid (ASA) in low doses has been recommended by some authors for pregnant women who contract SARS-CoV-2 before the 28th week of gestation to prevent PE/HELLP syndrome [15] . Earlier studies, however, indicated low doses of ASA before the 16th week of gestation to prevent PE/HELLP syndrome when there is at least one major risk factor or two moderate risk factors [19] .…”

Section: Introductionmentioning

confidence: 99%

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HELLP syndrome and COVID-19: A minor revision of a possible new “COVID-19-linked HELLP-like syndrome”

Sobieray

Zanela

Padilha

et al. 2023

European Journal of Obstetrics & Gynecology and Reproductiv

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

HELLP syndrome and COVID-19: A minor revision of a possible new “COVID-19-linked HELLP-like syndrome”

Sobieray

Zanela

Padilha

et al. 2023

European Journal of Obstetrics & Gynecology and Reproductiv

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“…Microcirculation disturbance in the uterus and placenta induces adverse pregnancy outcomes, an example of which is preeclampsia. The Chinese Guidelines for the Diagnosis and Treatment of Pregnancy-Induced Hypertension [13] and the American College of Obstetricians and Gynecologists [14] recommend the application of low-dose aspirin as an anticoagulant in high-risk pregnant women in order to prevent preeclampsia. Aspirin irreversibly inhibits the synthesis of cyclooxygenase, regulates the ratio of prostaglandin to thromboxane A2, reduces hypoxia and ischemia in placental tissues, and prevents platelet aggregation, thereby effectively improving coagulation function in pregnant women, and preventing fibrin deposition [15].…”

Section: Discussionmentioning

confidence: 99%

Aspirin protects against preeclampsia via p38MAPK signaling pathway

Su¹,

Zhou²,

Zhen³

et al. 2023

Trop. J. Pharm Res

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Purpose: To investigate the protective effect of aspirin against preeclampsia and the involvement of p38MAPK signaling pathway in the process.Methods: Sixty pregnant women who underwent antenatal care and delivery at Chancheng Central Hospital from September 2020 to September 2022 were selected and equally assigned to control group (CG) and experimental group (EG). From the 12th week of gestation, EG was administered 100 mg of aspirin and 1000 mg of calcium carbonate daily, while CG was given only 1000 mg of calcium carbonate daily. Both groups were treated up to the 35th week of gestation. Thereafter, blood samples were taken for measurement of serum levels of p38MAPK. In addition, the blood pressure of the women was measured. The incidence of preeclampsia and maternal-infant outcomes were assessed.Results: EG had a lower p38MAPK level at week 35 of pregnancy, and lower blood pressure levels at the 27th and 35th weeks of gestation, than CG (p < 0.05). There were 5 cases of preeclampsia (16.7 %) in EG, and 13 cases (43.3 %) of preeclampsia in CG, with a lower incidence of preeclampsia in EG than in CG (ꭓ2 = 5.079, p < 0.05). The numbers of newborns through premature delivery and cesarean section, as well as Apgar score ≤ 7 were lower in EG than in CG (p < 0.05).Conclusion: Aspirin exerts a protective effect against preeclampsia through via p38MAPK signaling pathway. Therefore, aspirin treatment may be useful in reducing the incidence of preeclampsia and improving maternal-infant outcomes. However, further clinical trials are recommended prior to application in clinical practice.

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Preeclampsia in pregnant women with COVID-19: a prospective cohort study from two tertiary hospitals in Southern Brazil

Sobieray,

Carvalho,

Klas

et al. 2024

PeerJ

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Background COVID-19 is an infectious pathology that shows vascular changes during pregnancy, as well as in the placentas. The main objectives of this study were to estimate the prevalence and the risk factors for preeclampsia in hospitalized pregnant women with COVID-19. As well as comparing maternal and perinatal outcomes in hospitalized pregnant women with COVID-19 and preeclampsia with those without preeclampsia. Methods Prospective cohort study of 100 hospitalized pregnant women from two tertiary hospitals, diagnosed with COVID-19, and divided into two groups: PE+ group (pregnant women with COVID-19 and preeclampsia) and PE- group (pregnant women with COVID-19 without preeclampsia). These pregnant women had prevalence, risk factors, maternal and perinatal data analyzed. Results The prevalence of preeclampsia was 11%. Severe COVID-19 was the main risk factor for preeclampsia (OR = 8.18 [CI 1.53–43.52]), as well as fetal growth restriction was the main perinatal outcome (OR = 8.90 [CI 1.52–38.4]). Comorbidities were more frequent in the PE+ group (63.6% vs 31.5%, p = 0.03), as well as prematurity (81.8% vs 41.6%, p = 0.02), low birth weight (63.6% vs 24.7%, p = 0.01), and the need for neonatal intensive care admission of the newborn (63.6% vs 27.0%, p = 0.03). Pregnant women with PE had twice as long a length of stay in the intensive care unit (RR = 2.35 [CI 1.34–4.14]). Although maternal mortality was more frequent among pregnant women with PE, it was not statistically significant. Conclusions Prevalence of preeclampsia in hospitalized pregnant women with COVID-19 was 11%. Severe COVID-19 was the main risk factor for preeclampsia and associated comorbidities increased the risk for developing preeclampsia. Long length of stay in the intensive care unit was the main maternal outcome and fetal growth restriction was the main perinatal outcome of preeclampsia.

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Is COVID-19 disease a risk factor for preeclampsia? Should aspirin be considered for prophylaxis of preeclampsia in these patients?

Cited by 3 publications

References 4 publications

HELLP syndrome and COVID-19: A minor revision of a possible new “COVID-19-linked HELLP-like syndrome”

HELLP syndrome and COVID-19: A minor revision of a possible new “COVID-19-linked HELLP-like syndrome”

Aspirin protects against preeclampsia via p38MAPK signaling pathway

Preeclampsia in pregnant women with COVID-19: a prospective cohort study from two tertiary hospitals in Southern Brazil

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