Gestational diabetes modifies the association between PlGF in early pregnancy and preeclampsia in women with obesity
Year: 2018
Type: article
Abstract: OBJECTIVE: To identify clinical and biomarker risk factors for preeclampsia in women with obesity and to explore interactions with gestational diabetes, a condition associated with preeclampsia. STUDY DESIGN: ) from the UK Pregnancies Better Eating and Activity Trial (UPBEAT), we examined 8 clinical factors (socio-demographic characteristics, BMI, waist circumference and clinical variables) and 7 biomarkers (HDL cholesterol, hemoglobin A1c, adiponectin, interleukin-6, high sensitivity C-reactive protein, and placental growth factor (PlGF)) in the early second trimester for association with later development of preeclampsia using logistic regression. Factors were selected based on prior association with preeclampsia. Interaction with gestational diabetes was assessed. MAIN OUTCOME MEASURE: Preeclampsia. RESULTS: Prevalence of preeclampsia was 7.3% (59/824). Factors independently associated with preeclampsia were higher mean arterial blood pressure (Odds Ratio (OR) 2.22; 95% Confidence Interval (CI) 1.58-3.12, per 10 mmHg) and lower PlGF (OR 1.39; 95% CI 1.03-1.87, per each lower 1 log2). The association of PlGF with preeclampsia was present amongst obese women without gestational diabetes (OR 1.91; 95% CI 1.32-2.78), but not in those with GDM (OR 1.05; 95% CI 0.67-1.63), p = 0.04 for interaction. CONCLUSION: The relationship between PlGF and preeclampsia differed in women with obesity according to gestational diabetes status, which may suggest different mechanistic pathways to preeclampsia. Whilst replication is required in other populations, this study suggests that performance of prediction models for preeclampsia should be confirmed in pre-specified subgroups.
Source: Pregnancy Hypertension
Institutions: King's College London, Pontifícia Universidade Católica do Rio Grande do Sul, Imperial College London, Guy's and St Thomas' NHS Foundation Trust, University Hospital Southampton NHS Foundation Trust, NIHR Southampton Biomedical Research Centre, MRC Lifecourse Epidemiology Unit, University of Southampton, University Hospitals Bristol NHS Foundation Trust, University of Bristol, NIHR Bristol Biomedical Research Centre, MRC Integrative Epidemiology Unit, University of Glasgow
Language: English
Subfield: Obstetrics and Gynecology
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $3,150
Funders: University Hospitals Bristol NHS Foundation Trust, NIHR Bristol Biomedical Research Centre, National Institute for Health and Care Research, British Heart Foundation, Diabetes UK, Guy's and St Thomas' Charity, Chief Scientist Office, King's College London, European Commission, University of Bristol, Coordenação de Aperfeiçoamento de Pessoal de Nível Superior, Tommy's, National Institute for Health Research Southampton Biomedical Research Centre, Manchester Biomedical Research Centre, Medical Research Council, Menzies Centre for Australian Studies, King's College London, University of London, Guy's and St Thomas' NHS Foundation Trust, Seventh Framework Programme, National Institute of Diabetes and Digestive and Kidney Diseases
Awards: The UPBEAT RCT mother-child study. Stratifying and treating obese pregnant women to prevent adverse pregnancy, perinatal and longer term outcomes., G2030072381, G2892497062, G2967104140, G297885364, NIHR Senior Investigator Award, NIHR Senior Investigator Award, Improving pregnancy outcome in obese women, G5097586893, NIHR Senior Investigator Award, Epigenetic biomarkers and determinants of cardiovascular risk in children, G6785345317, Metabolomic and Epigenomic Mechanisms in Developmental Overnutrition., Early prediction of Gestational Diabetes Mellitus (GDM) in obese women using clinical characteristics and metabolic biomarkers, Nutrition, Development and Lifelong Health: Studies in European Populations, Maternal vitamin B12, folic acid and homocysteine as determinants of gestational diabetes, fetal growth and intergenerational programming of diabesity, G8537530744, Long-term effects of early nutrition on later health
OpenAlex ID: W2874753587