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Biochemical and Epi...
Biochemical and Epidemiological Studies of Early-Onset and Late-Onset Pre-Eclampsia
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- Wikström, Anna-Karin, 1965- (författare)
- Uppsala universitet,Institutionen för kvinnors och barns hälsa
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Olovsson, Matts (preses)
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Eriksson, Ulf (preses)
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Norden-Lindeberg, Solveig (preses)
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- Berg, Göran, Docent (opponent)
- Institutionen för molekylär och klinisk medicin; avdelningen för Obstetrik och Gynekologi., Linköping
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(creator_code:org_t)
- ISBN 9789155470012
- Uppsala : Acta Universitatis Upsaliensis, 2007
- Engelska 80 s.
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Serie: Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, 1651-6206 ; 282
- Relaterad länk:
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https://uu.diva-port... (primary) (Raw object)
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https://uu.diva-port...
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https://urn.kb.se/re...
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Abstract
Ämnesord
Stäng
- Biochemical and epidemiological aspects of pre-eclampsia were investigated, with the main focus on possible pathophysiological differences between early-onset and late-onset disease.In pre-eclamptic women poor correlation was found between albumin-creatinine ratio (ACR) in a random urine sample and total amount of albumin in a 24-hour urine collection. (Paper I) In a cohort of women giving birth in Sweden in 1973-82 we estimated the adjusted incidence rate ratio (IRR) for ischaemic heart disease (IHD) during the years 1987–2001. The adjusted IRR for development of IHD was 1.6-2.8 in woman exposed to gestational hypertensive disease during her pregnancy compared with unexposed women. The higher risk represents more severe or recurrent hypertensive disease. (Paper II)Before delivery, in early-onset pre-eclampsia (24-32 weeks) there were pronounced alterations in plasma concentrations of soluble fms-like tyrosine kinase 1 (sFlt1) and placental growth factor (PlGF), and also a higher placental 8-iso-PGF2α concentration and an elevated serum ratio of plasminogen-activator inhibitor (PAI)-1 to PAI-2 compared with early controls. In late-onset pre-eclampsia (35-42 weeks) there were only moderate alterations in sFlt1 and PlGF concentrations, and the placental 8-iso-PGF2α concentration and PAI-1/ PAI-2 ratio were similar to those in late controls. (Papers III, V) There was a rapid postpartum decrease in sFlt1 concentration in all groups. One week postpartum the sFlt1 concentration was persistently higher, however, in women with early-onset pre-eclampsia compared with early controls. (Paper IV)In conclusion: random ACR cannot replace 24-hour urine collections for quantification of albuminuria in pre-eclamptic women; gestational hypertensive disease, especially severe or recurrent, increases the risk for later IHD; early-onset, but not late-onset pre-eclampsia is associated with pronounced alterations of angiogenesis-related markers and only early-onset pre-eclampsia is associated with placental oxidative stress and an increased PAI-1/ PAI-2 ratio, all suggesting a stronger link between early-onset than late-onset pre-eclampsia and a dysfunctional placenta.
Nyckelord
- Obstetrics and gynaecology
- pre-eclampsia
- proteinuria
- albumin-creatinine ratio
- ischaemic heart disease
- angiogenesis
- sFlt1
- oxidative stress
- isoprostane
- PAI-1
- PAI-2
- Obstetrik och kvinnosjukdomar
Publikations- och innehållstyp
- vet (ämneskategori)
- dok (ämneskategori)
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