Pre-pregnancy stress induces maternal vascular dysfunction during pregnancy and postpartum.

An estimated 20% of women suffer from a stress-related mood disorder including depression and anxiety during and after pregnancy, making these disorders among the most common complications of pregnancy. These stress-related disorders are associated with adverse pregnancy outcomes including gestational hypertension and preeclampsia, which are associated with poor cardiometabolic health postpartum. Despite these associations, the direct impact of stress and related disorders on maternal vascular health, and contributing mechanisms, remain understudied.

l-Citrulline supplementation during pregnancy improves perinatal and postpartum maternal vascular function in a mouse model of preeclampsia.

Preeclampsia is a spontaneously occurring pregnancy complication diagnosed by new-onset hypertension and end-organ dysfunction with or without proteinuria. This pregnancy-specific syndrome contributes to maternal morbidity and mortality and can have detrimental effects on fetal outcomes. Preeclampsia is also linked to increased risk of maternal cardiovascular disease throughout life.

Paternal deficiency of complement component C1q leads to a preeclampsia-like pregnancy in wild-type female mice and vascular adaptations postpartum.

Preeclampsia is a spontaneously occurring, pregnancy-specific syndrome that is clinically diagnosed by new onset hypertension and proteinuria. Epidemiological evidence describes an association between a history of preeclampsia and increased risk for cardiovascular disease in later life; however, the mechanism(s) driving this relationship are unclear. Our study aims to leverage a novel preeclampsia-like mouse model, the C1q model, to help elucidate the acute and persistent vascular changes during and following a preeclampsia-like pregnancy.

Urinary cortisol and depression in early pregnancy: role of adiposity and race.

Background: Depression before and during pregnancy is associated with adverse birth outcomes including low birth weight and preterm birth. Abnormal maternal cortisol has been hypothesized as one mediator between depression and adverse birth outcomes. The relationship between cortisol and depression in pregnancy is exhibited most strongly in the African American population, and most studies have focused either on circulating or placental levels of cortisol.

The -93T/G LPL Promoter Polymorphism Is Associated With Lower Third-Trimester Triglycerides in Pregnant African American Women.

Background: Hypertriglyceridemia is a risk factor for cardiovascular disease and several pregnancy complications. Lipoprotein lipase (LPL) genetic variation modulates nonpregnancy plasma triglycerides, but its effects during pregnancy are unknown. The G allele of the LPL -93T/G promoter polymorphism is 16-23 times more prevalent in Blacks than in Whites, contributing to lower triglycerides in nonpregnant African Americans by increasing LPL expression.

An exploratory factor analysis of nutritional biomarkers associated with major depression in pregnancy.

Objective: Major depressive disorder (MDD) during pregnancy increases the risk of adverse maternal and infant outcomes. Maternal nutritional status may be a modifiable risk factor for antenatal depression. We evaluated the association between patterns in mid-pregnancy nutritional biomarkers and MDD.

Is there evidence of separate inflammatory or metabolic forms of preeclampsia?

Objectives: To examine whether high insulin resistance versus high inflammation identifies subtypes of preeclampsia.

Methods: A cytokine panel, glucose and insulin were measured in 37 preeclampsia plasma samples. Wilcoxon rank sum assessed median concentration of HOMA(IR) by pro-inflammatory:anti-inflammatory ratio.

Plasma levels of inflammatory markers neopterin, sialic acid, and C-reactive protein in pregnancy and preeclampsia.

Background: To determine whether the cellular inflammatory marker of activated macrophages and monocytes, neopterin (NEO), and the acute-phase inflammatory markers sialic acid (SA) and C-reactive protein (CRP) are elevated in pregnancy and further elevated in the pregnancy syndrome preeclampsia.

Methods: Maternal plasma concentrations of NEO, SA, and CRP were measured by high-sensitivity enzyme-linked immunosorbent assay (ELISA) or high-performance liquid chromatography in 20 nonpregnant women, 40 women with uncomplicated pregnancies, 50 women with transient hypertension of pregnancy alone, 49 women with small for gestational age (SGA) infants without preeclampsia, and 47 women with preeclampsia.

Results: The mean concentration of plasma NEO, SA, and CRP were all significantly elevated in all groups of pregnant women compared to nonpregnant women (P < 0.

Preeclampsia risk and angiotensinogen polymorphisms M235T and AGT -217 in African American and Caucasian women.

Introduction: Genetic variants of the angiotensinogen gene have been linked to both hypertension and preeclampsia. The M235T polymorphism is more common in hypertension and preeclampsia in some populations. A polymorphism in the angiotensinogen basal promoter region of AGT -217 is more common in African Americans with hypertension.

Evidence of endothelial dysfunction in preeclampsia and risk of adverse pregnancy outcome.

The purpose of this study is to investigate whether endothelial dysfunction, as assessed by elevated cellular fibronectin (cFN), in women with preeclampsia is associated with an increased risk of preterm and/or small-for-gestational-age (SGA) births. Maternal plasma cFN was measured by enzyme-linked immunosorbent assay in samples collected at admission to delivery in 605 normotensive women, 171 women with transient hypertension, and 187 women with preeclampsia. Logistic regression was used to estimate the risk for preterm delivery, SGA, or both.

Maternal leptin concentrations are similar in African Americans and Caucasians in normal pregnancy, preeclampsia and small-for-gestational-age infants.

Leptin concentrations were measured in African American women in order to assess leptin's role in the increased frequency and severity of preeclampsia. In addition, leptin concentrations were measured in women who delivered small-for-gestational-age (SGA) infants. A case-control study of African American and Caucasian women with normal pregnancies, preeclampsia, or SGA infants was done.

Angiotensin II decreases system A amino acid transporter activity in human placental villous fragments through AT1 receptor activation.

Reduced transport of amino acids from mother to fetus can lead to fetal intrauterine growth restriction (IUGR). The activities of several amino acid transport systems, including system A, are decreased in placental syncytiotrophoblast of IUGR pregnancies. Na(+)-K(+)-ATPase activity provides an essential driving force for Na(+)-coupled system A transport, is decreased in the placenta of IUGR pregnancies, and is decreased by angiotensin II in several tissues.

Uric acid concentrations in early pregnancy among preeclamptic women with gestational hyperuricemia at delivery.

Objective: We investigated changes in serum uric acid across pregnancy in women with gestational hyperuricemia at delivery, with and without preeclampsia, compared with normal pregnant and women with preeclampsia without gestational hyperuricemia.

Study Design: This was a nested case-control study of 116 controls, 27 women with preeclampsia with predelivery hyperuricemia, 37 women with preeclampsia without predelivery hyperuricemia, and 35 women with gestational hypertension with hyperuricemia at delivery but without proteinuria. Serum uric acid and creatinine was measured across pregnancy.

The 677 C-T methylenetetrahydrofolate reductase mutation does not predict increased maternal homocysteine during pregnancy.

Objective: To test the hypothesis that, regardless of the presence of the 677 C-T methylenetetrahydrofolate reductase (MTHFR) mutation, maternal homocysteine concentrations will not be significantly different in women who are taking prenatal vitamins containing folic acid, and to test this relationship in preeclampsia because homocysteine concentrations are higher in preeclamptic pregnancies.

Methods: Fifty-seven pregnant white women (control and preeclamptic) with and without the 677 C-T MTHFR mutation were studied. Total plasma homocysteine and plasma folic acid were analyzed.