Recurrence of hypertensive disorders of pregnancy: an individual patient data metaanalysis

Oostwaard, Miriam F. Van; Langenveld, Josje; Schuit, Ewoud; Papatsonis, Dimitri; Brown, Mark; Byaruhanga, Romano; Bhattacharya, Sohinee; Campbell, Doris M.; Chappell, Lucy C; Chiaffarino, Francesça; Crippa, Isabella; Facchinetti, Fabio; Ferrazzani, Sergio; Ferrazzi, E.; Figueiró-Filho, Ernesto Antônio; Gaugler-Senden, Ingrid P.M.; Haavaldsen, Camilla; Lykke, Jacob Alexander; Mbah, Alfred K.; Oliveira, Vanessa Marcon de; Poston, Lucilla; Redman, Christopher W.G.; Salim, Raed; Thilaganathan, B.; Vergani, Patrizia; Zhang, Jun; Steegers, Eric A.P.; Mol, Ben Willem; Ganzevoort, Wessel

doi:10.1016/j.ajog.2015.01.009

Cited by 123 publications

(98 citation statements)

References 48 publications

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“…This might account for the lower HDP rate in our study (7% of all deliveries) compared with prior studies showing rates of 10%–15% 10. We could not evaluate recurrent HDP cases in our analysis, although women with HDP have a 9%–14% risk of recurrent HDP during subsequent pregnancies28 and recurrent HDP may be associated with higher CV risk 29. Our data are limited to in-hospital deliveries and events only.…”

Section: Discussionmentioning

confidence: 99%

Short-term risk of cardiovascular readmission following a hypertensive disorder of pregnancy

Jarvie

Metz

Davis

et al. 2018

Heart

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Section: Discussionmentioning

confidence: 99%

Short-term risk of cardiovascular readmission following a hypertensive disorder of pregnancy

Jarvie

Metz

Davis

et al. 2018

Heart

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“…2). Potential downsides to this approach include: (i) preeclampsia per se in the index pregnancy may adversely affect endometrial maturation in subsequent menstrual cycles, (ii) the quality and extent of pre-decidualization in the conceptive cycle preceding the index preeclamptic pregnancy may not be the same in subsequent non-conceptive cycles, and (iii) preeclampsia recurrence is only ~ 20% [117]. With respect to the first of these potential pitfalls, a positive study outcome could be followed up in future investigations of banked, formalin-fixed paraffin embedded (FFPE) endometrial biopsies that were obtained prior to assisted reproductive cycles (“mock” cycles) starting with identification of obstetrical outcomes and followed by gene expression analysis (technology for extracting sufficient quality RNA from FFPE tissues for gene expression analysis is emerging).…”

Section: Future Investigationsmentioning

confidence: 99%

Emerging role for dysregulated decidualization in the genesis of preeclampsia

2017

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In normal human placentation, uterine invasion by trophoblast cells and subsequent spiral artery remodeling depend on cooperation among fetal trophoblasts and maternal decidual, myometrial, immune and vascular cells in the uterine wall. Therefore, aberrant function of anyone or several of these cell-types could theoretically impair placentation leading to the development of preeclampsia. Because trophoblast invasion and spiral artery remodeling occur during the first half of pregnancy, the molecular pathology of fetal placental and maternal decidual tissues following delivery may not be informative about the genesis of impaired placentation, which transpired months earlier. Therefore, in this review, we focus on the emerging prospective evidence supporting the concept that deficient or defective endometrial maturation in the late secretory phase and during early pregnancy, i.e., pre-decidualization and decidualization, respectively, may contribute to the genesis of preeclampsia. The first prospectively-acquired data directly supporting this concept were unexpectedly revealed in transcriptomic analyses of chorionic villous samples (CVS) obtained during the first trimester of women who developed preeclampsia 5 months later. Additional supportive evidence arose from investigations of Natural Killer cells in first trimester decidua from elective terminations of women with high resistance uterine artery indices, a surrogate for deficient trophoblast invasion. Last, circulating insulin growth factor binding protein-1, which is secreted by decidual stromal cells was decreased during early pregnancy in women who developed preeclampsia. We conclude this review by making recommendations for further prospectively-designed studies to corroborate the concept of endometrial antecedents of preeclampsia. These studies could also enable identification of women at increased risk for developing preeclampsia, unveil the molecular mechanisms of deficient or defective (pre)decidualization, and lead to preventative strategies designed to improve (pre)decidualization, thereby reducing risk for preeclampsia development.

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“…Interestingly, the list of predisposing factors for PE is almost the same as that for CKD, once more stressing the similarities between these diseases ( Table 2). Further elements, including genetic predisposition, are included in the list of risk factors for recurrent PE; once again, the similarities with CKD are evident [65][66][67][68][69][70][71][72][73][74][75][76][77][78][79]. However, in most of these lists there is an important overlap between predisposing maternal diseases, including CKD, and specific conditions that may impair placentation, including parity or genetic factors.…”

Section: Introductionmentioning

confidence: 96%

A best practice position statement on the role of the nephrologist in the prevention and follow-up of preeclampsia: the Italian study group on kidney and pregnancy

Piccoli

Cabiddu

Castellino³

et al. 2017

J Nephrol

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Preeclampsia (PE) is a protean syndrome causing a transitory kidney disease, characterised by hypertension and proteinuria, ultimately reversible after delivery. Its prevalence is variously estimated, from 3 to 5% to 10% if all the related disorders, including also pregnancy-induced hypertension (PIH) and HELLP syndrome (haemolysis, increase in liver enzyme, low platelets) are included. Both nephrologists and obstetricians are involved in the management of the disease, according to different protocols, and the clinical management, as well as the role for each specialty, differs worldwide. The increased awareness of the role of chronic kidney disease in pregnancy, complicating up to 3% of pregnancies, and the knowledge that PE is associated with an increased risk for development of CKD later in life have recently increased the interest and redesigned the role of the nephrologists in this context. However, while the heterogeneous definitions of PE, its recent reclassification, an emerging role for biochemical biomarkers, the growing body of epidemiological data and the new potential therapeutic interventions lead to counsel long-term follow-up, the lack of resources for chronic patients and the increasing costs of care limit the potential for preventive actions, and suggest tailoring specific interventional strategies. The aim of the present position statement of the Kidney and Pregnancy Study Group of the Italian Society of Nephrology is to review the literature and to try to identify theoretical and pragmatic bases for an agreed management of PE in the nephrological setting, with particular attention to the prevention of the syndrome (recurrent PE, presence of baseline CKD) and to the organization of the postpartum follow-up.

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Recurrence of hypertensive disorders of pregnancy: an individual patient data metaanalysis

Cited by 123 publications

References 48 publications

Short-term risk of cardiovascular readmission following a hypertensive disorder of pregnancy

Short-term risk of cardiovascular readmission following a hypertensive disorder of pregnancy

Emerging role for dysregulated decidualization in the genesis of preeclampsia

A best practice position statement on the role of the nephrologist in the prevention and follow-up of preeclampsia: the Italian study group on kidney and pregnancy

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