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. Elevated cFN in women with preeclampsia was associated with an increased risk of both preterm and SGA births (odds ratio, 3.0; confidence interval [CI], 1.0-8.7) compared with women with preeclampsia without elevated cFN. The risk of preterm birth was 14.7-fold higher (CI, 8.1-26.7) and the risk of SGA was 6.8-fold higher (CI, 3.5-13.1) in women with preeclampsia, hyperuricemia, and elevated cFN compared with normotensive women. Elevated cFN is prevalent among women with preeclampsia and identifies women at increased risk of preterm delivery and SGA.
Powers
Robert W
RW
Magee-Womens Research Institute, Pittsburgh, Pennsylvania (RWP, JMC, LMB, MJG, JMR); Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania (RWP, LMB, JMR); Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania (JMC, LMB, JMR); and Department of Obstetrics and Gynecology, University of Kentucky, Lexington (KYL).
Catov
Janet M
JM
Magee-Womens Research Institute, Pittsburgh, Pennsylvania (RWP, JMC, LMB, MJG, JMR); Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania (RWP, LMB, JMR); Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania (JMC, LMB, JMR); and Department of Obstetrics and Gynecology, University of Kentucky, Lexington (KYL).
Bodnar
Lisa M
LM
Magee-Womens Research Institute, Pittsburgh, Pennsylvania (RWP, JMC, LMB, MJG, JMR); Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania (RWP, LMB, JMR); Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania (JMC, LMB, JMR); and Department of Obstetrics and Gynecology, University of Kentucky, Lexington (KYL).
Gallaher
Marcia J
MJ
Magee-Womens Research Institute, Pittsburgh, Pennsylvania (RWP, JMC, LMB, MJG, JMR); Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania (RWP, LMB, JMR); Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania (JMC, LMB, JMR); and Department of Obstetrics and Gynecology, University of Kentucky, Lexington (KYL).
Lain
Kristine Y
KY
Magee-Womens Research Institute, Pittsburgh, Pennsylvania (RWP, JMC, LMB, MJG, JMR); Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania (RWP, LMB, JMR); Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania (JMC, LMB, JMR); and Department of Obstetrics and Gynecology, University of Kentucky, Lexington (KYL).
Roberts
James M
JM
Magee-Womens Research Institute, Pittsburgh, Pennsylvania (RWP, JMC, LMB, MJG, JMR); Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania (RWP, LMB, JMR); Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania (JMC, LMB, JMR); and Department of Obstetrics and Gynecology, University of Kentucky, Lexington (KYL).
D000293:Adolescent; D000328:Adult; D015415:Biomarkers / Q000097:blood; D001724:Birth Weight; D016022:Case-Control Studies; D004727:Endothelium / Q000378:metabolism; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005353:Fibronectins / Q000097:blood*; D005865:Gestational Age; D006801:Humans; D046110:Hypertension, Pregnancy-Induced; D033461:Hyperuricemia / Q000150:complications; D007231:Infant, Newborn; D007234:Infant, Premature; D007236:Infant, Small for Gestational Age; D016015:Logistic Models; D008297:Male; D016017:Odds Ratio; D011225:Pre-Eclampsia / Q000097:blood*; D011247:Pregnancy; D011256:Pregnancy Outcome; D047928:Premature Birth / Q000097:blood* / Q000453:epidemiology; D012307:Risk Factors; D018709:Statistics, Nonparametric
D015415:Biomarkers; D005353:Fibronectins