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Effects of preeclampsia on the yield of hematopoietic stem cells obtained from umbilical cord blood at delivery

Wahid FS, Nasaruddin MZ, Idris MR, Tusimin M, Tumian NR, Mahdy ZA

J Obstet Gynaecol Res, 2012 Mar;38(3):490-7.
PMID: 22381102 DOI: 10.1111/j.1447-0756.2011.01740.x

To compare the numbers of cord blood CD34(+) hematopoietic stem cells (HSC) between preeclampsia (PE) and control (non-PE) subjects and to determine the factors that may influence this observation.

Matched MeSH terms: Pre-Eclampsia/blood*
High-Sensitivity Cardiac Troponin I Levels in Normal and Hypertensive Pregnancy

Ravichandran J, Woon SY, Quek YS, Lim YC, Noor EM, Suresh K, et al.

Am J Med, 2019 03;132(3):362-366.
PMID: 30503877 DOI: 10.1016/j.amjmed.2018.11.017

PURPOSE: The purpose of this study was to examine the association of circulating concentrations of high-sensitivity cardiac troponin I (hs-cTn) in the various trimesters of pregnancy in patients with and without hypertension.
METHODS: This was a prospective cross-sectional study of pregnant and postnatal women aged between 18-35 years with no coexisting diseases. Serum samples were analysed for hs-TnI.
RESULTS: A total of 880 women (mean age = 29.1 years [standard deviation = 5.1 years]) were recruited with 129 (14%), 207 (24%), and 416 (47%) patients in the first, second, and third trimesters, respectively. Ninety (10%) participants were recruited in the postnatal period. During pregnancy 28 (3%) patients were classified as having pregnancy-induced hypertension and 10 (1%) as preeclampsia. High-sensitivity cardiac troponin I was measurable in 546 (62%) participants with a median of 1 ng/L (range 0 to 783 ng/L). Troponin concentrations were above the 99th percentile in 19 (2%) individuals. Patients with pregnancy-induced hypertension and preeclampsia had higher concentrations of hs-TnI (median 11 ng/L [interquartile range (IQR) 6 to 22 ng/L] vs 12ng/L [IQR 3 to 98 ng/L] vs 1 ng/L [IQR 0 to 1 ng/L]). In logistic regression modeling hs-cTnI concentration remained an independent predictor of pregnancy-induced hypertension or preeclampsia in both unadjusted and adjusted models (odds ratio 9.3 [95% confidence interval 5.8 to 16.3] and 11.5 [95% confidence interval 6.3 to 24.1], respectively, per doubling of hs-TnI concentrations).
CONCLUSIONS: Cardiac troponin measured using a high-sensitivity assay is quantifiable in the majority of young pregnant women with 2% of individuals having concentration above the 99th percentile sex-specific threshold. Patients with pregnancy-induced hypertension or preeclampsia had higher cardiac troponin concentrations. Cardiac troponin was a strong independent predictor of pregnancy-induced hypertension or preeclampsia in pregnant and postnatal women.

Matched MeSH terms: Pre-Eclampsia/blood*
Fulltext Serum soluble FMS-like tyrosine kinase 1 and placental growth factor concentration as predictors of preeclampsia in high risk pregnant women

Hanita O, Alia NN, Zaleha AM, Nor Azlin MI

Malays J Pathol, 2014 Apr;36(1):19-26.
PMID: 24763231 MyJurnal

Soluble fms-like tyrosine kinase-1 (sFlt-1) and placental growth factor (PlGF) contribute in the development of preeclampsia and are suggested as prediction markers in healthy pregnant women but limited data is available in women with major preeclampsia risk factors. This study aimed to determine the role of sFlt-1 and PlGF in predicting preeclampsia among high risk pregnant women. This was a prospective study and samples were collected for a period of ten months. Blood samples were obtained from 84 pregnant women who had at least one risk factor for preeclampsia at 25 to 28 weeks and at 29 to 36 weeks of gestation. SFlt-1 and PlGF concentrations were determined by immunoassay method. There were significantly higher median sFlt-1 and sFlt-1:PlGF ratio at gestational interval 25 to 28 weeks and sFlt-1:PlGF ratio at 29 to 36 weeks in high risk women who developed preeclampsia. Significant lower median serum PlGF levels at 25 to 28 weeks and 29 to 36 weeks were observed in this group of women. In conclusion, the concentrations of these markers were altered in high risk preeclamptic women, a similar pattern seen in low risk preeclamptic women. However the predictive value of these markers could not be established clearly.

Matched MeSH terms: Pre-Eclampsia/blood*
Fulltext Preeclampsia in pregnancy affecting the stemness and differentiation potency of haematopoietic stem cell of the umbilical cord blood

Nordin F, Idris MRM, Mahdy ZA, Wahid SFA

BMC Pregnancy Childbirth, 2020 Jul 10;20(1):399.
PMID: 32650736 DOI: 10.1186/s12884-020-03084-7

BACKGROUND: Umbilical cord blood (UCB) has been proposed as the potential source of haematopoietic stem cells (HSC) for allogeneic transplantation. However, few studies have shown that a common disease in pregnancy such as preeclampsia would affect the quality of UCB-HSC. Total nucleated cell count (TNC) is an important parameter that can be used to predict engraftment including UCB banking. Colony forming unit (CFU) assay is widely used as an indicator to predict the success of engraftment, since direct quantitative assay for HSC proliferation is unavailable. The aim of this study is to investigate the effects of preeclampsia in pregnancy on the stemness and differentiation potency of UCB-HSC.
METHODS: Mononuclear cells (MNC) were isolated from UCB and further enriched for CD34+ cells using immune-magnetic method followed by CFU assay. A panel of HSC markers including differentiated haematopoietic markers were used to confirm the differentiation ability of UCB-HSC by flow cytometry analysis.
RESULTS/ DISCUSSION: The HSC progenitor's colonies from the preeclampsia group were significantly lower compared to the control. This correlates with the low UCB volume, TNC and CD34+ cells count. In addition, the UCB-enriched CD34+ population were lymphoid progenitors and capable to differentiate into natural killer cells and T-lymphocytes.
CONCLUSION: These findings should be taken into consideration when selecting UCB from preeclamptic mothers for banking and predicting successful treatment related to UCB transplant.

Matched MeSH terms: Pre-Eclampsia/blood*
Foetal and maternal outcomes in hyperuricaemia pre-eclampsia patients in Hospital Universiti Sains Malaysia

Jummaat F, Adnan AS, Ab Hamid SA, Hor JN, Nik Mustofar NN, Muhammad Asri NA, et al.

J Obstet Gynaecol, 2021 Jan;41(1):38-43.
PMID: 33124936 DOI: 10.1080/01443615.2019.1679731

Preeclampsia patients have frequently been found to experience hyperuricaemia and this may result in poor outcomes compared to those with normal uric acid levels. This study aimed to determine the relationship of hyperuricaemia in pre-eclampsia patients with foetal and maternal outcomes. This prospective cohort study involved 79 patients in a tertiary centre from year 2016 to 2018. Blood samples were taken antenatally and at the 6th week, post-delivery for renal function including serum uric acid level. Our findings indicate that there was a higher incidence of poor maternal and foetal outcomes in the hyperuricaemia group than the normal uric acid group. Serum uric acid has been shown to be a significant predictor for low birth weight and premature delivery in preeclampsia patients. It was also found that there was a significant negative correlation between uric acid level and antenatal creatinine clearance (rs = -0.338, p = .002). The assessment of the serum uric acid level seems to be important to ensure better outcomes in patients with preeclampsia.Impact statementWhat is already known on this subject? Preeclampsia is a serious pregnancy-related complication and remains as one of the most important cause of maternal and foetal morbidity and mortality, affecting 2-8% in all pregnancy. Many studies have established the association between hyperuricaemia and preeclampsia. Besides, numerous studies have found that hyperuricaemia contributed to adverse maternal and foetal outcomes.What the results of this study add? There was a significant increase in adverse foetal and maternal outcomes in the hyperuricaemia group compared to the normal uric acid group. This study revealed that serum uric acid remains a significant predictor for low birth weight and premature delivery in preeclampsia patients.What the implications are of these findings for clinical practice and/or further research? Hyperuricaemia does not merely become an indicator for the severity of disease in preeclampsia patients but also indicates adverse foetal outcomes. Large population-based studies are required to establish the absolute maternal and foetal outcomes in patients with hyperuricaemia. Besides, further studies are recommended on long-term implication of hyperuricaemia which is not limited to only during antenatal period.

Matched MeSH terms: Pre-Eclampsia/blood
Fulltext Determination of mineral, parathyroid hormone, and 6-keto-prostaglandin-F1 alpha levels in pregnant women with hypertension and pre-eclampsia

Sulaiman S, Adeeb N, Muslim N, Adeeb N, Ho CM

Singapore Med J, 1995 Dec;36(6):637-40.
PMID: 8781637

Determinations of total calcium, total magnesium, calcium ion, parathyroid hormone and 6-keto-prostaglandin-F1 alpha levels were carried out on 84 blood samples from 4 groups of women categorised as non-pregnant normotensive (NNP), pregnant normotensive (NP), pregnancy-induced hypertension (PIH) and pre-eclampsia (PE). PIH was clinically diagnosed when the diastolic pressure was more than 90 mmHg and was only hypertensive during pregnancy while PE was with additional proteinuria after 20 weeks of gestation. Compared to NNP women, total calcium and parathyroid hormone levels were of lower levels (p < 0.05) in NP women while in PIH women, total calcium and 6-keto-prostaglandin-F1 alpha levels were also lowered (p < 0.05). Compared to NNP women, PE women's levels of total calcium, calcium ion and 6-keto-prostaglandin-F1 alpha decreased (p < 0.05) while parathyroid hormone level increased (p < 0.05). When compared to the NP women, PE women had decreased levels (p < 0.05) of total calcium as well as calcium ion and increased level (p < 0.05) of parathyroid hormone. Calcium ion was found to be negatively correlated (NNP : r = -0.883, p = 0.008/NP : r = -0.931, p = 0.000) while parathyroid hormone was positively correlated (NNP : r = 0.904, p = 0.013/NP : r = 0.913, p = 0.000) with mean arterial pressure.

Matched MeSH terms: Pre-Eclampsia/blood
The relation of preeclampsia and serum level of 25-hydroxyvitamin D in mothers and their neonates: a case control study in Iran

Mohaghegh Z, Abedi P, Dilgouni T, Namvar F, Ruzafza S

Horm. Metab. Res., 2015 Apr;47(4):284-8.
PMID: 25611206 DOI: 10.1055/s-0034-1395607

The predisposing factors of preeclampsia may endanger the mother's heath as well as her neonate. One hypothesis related to preeclampsia is vitamin D deficiency or insufficiency. This study was conducted to evaluate the relationship between preeclampsia and the serum level of 25-hydroxyvitamin D (25-OH-D) in mothers and their neonates. In this case-control study, we recruited 41 preeclamptic and 50 healthy women from the Imam Khomeini Hospital in Ahvaz, Iran. Venous blood (2 ml) from mothers (in time of labor) and 2 ml of blood from the umbilical cord were taken, centrifuged, stored at -30°C and sent to a laboratory for analysis of 25-OH-D by ELISA. Vitamin D levels<20 ng/ml were regarded as deficiency, levels between 21-29 ng/ml were regarded as insufficiency, and if levels were higher than 30 ng/ml, these were considered normal. Independent t-test, chi-square, Spearman correlation coefficient and logistic regression were used to analyze data. Mean levels of 25-OH-D were significantly lower in preeclamptic women (15.2±13.6 vs. 23.3±15.3 ng/ml, p=0.001) and in their neonates (15.2±13.1 vs. 21.6±12.6 ng/ml, p=0.01) compared to normal pregnant women and their neonates. There was a significant relationship between the levels of vitamin D in preeclamptic women with levels of this vitamin in their neonates (r=0.901, p=0.0001). 25-OH-D deficiency that exist in preeclamptic mothers, may be a health risk for their infants, therefore, early use of vitamin D supplement with higher dose than 400 IU in Iranian women is recommended.

Matched MeSH terms: Pre-Eclampsia/blood*
Thrombophilic mutations in pre-eclampsia and pregnancy-induced hypertension

Omar SZ, Qvist R, Khaing SL, Muniandy S, Bhalla S

J Obstet Gynaecol Res, 2008 Apr;34(2):174-8.
PMID: 18412778 DOI: 10.1111/j.1447-0756.2008.00755.x

The aim of the present study was to determine the existence or prevalence of thrombophilic markers such as Factor V Leiden, prothrombin G20210A, protein S, protein C, activated protein C and anti-thrombin in pre-eclampsia and pregnancy-induced hypertensive patients.

Matched MeSH terms: Pre-Eclampsia/blood
The effects of hydroxychloroquine on endothelial dysfunction

Rahman R, Murthi P, Singh H, Gurusinghe S, Mockler JC, Lim R, et al.

Pregnancy Hypertens, 2016 Oct;6(4):259-262.
PMID: 27939463 DOI: 10.1016/j.preghy.2016.09.001

Hydroxychloroquine is an anti-malarial drug which, due to its anti-inflammatory and immunomodulatory effects, is widely used for the treatment of autoimmune diseases. In a model of systemic lupus erythematosus hydroxychloroquine has been shown to exert protective endothelial effects. In this study, we aimed to investigate whether hydroxychloroquine was endothelial protective in an in vitro model of TNF-α and preeclamptic serum induced dysfunction. We showed that hydroxychloroquine significantly reduced the production of TNF-α and preeclamptic serum induced endothelin-1 (ET-1). Hydroxychloroquine also significantly mitigated TNF-α induced impairment of angiogenesis. These findings support the further assessment of hydroxychloroquine as an adjuvant therapy in preeclampsia.

Matched MeSH terms: Pre-Eclampsia/blood