title: Fetal sex and the circulating renin-angiotensin system during early gestation in women who later develop preeclampsia or gestational hypertension.
abstract: There are fetal sex-specific differences in the balance between angiotensin (Ang) II and Ang-(1-7) in the maternal circulation during pregnancy. To determine whether at 15 weeks' gestation plasma levels of Ang II and Ang-(1-7), as well as levels of prorenin and Ang-converting enzyme (ACE), predicted the development of gestational hypertension (GH) or preeclampsia (PreE) and were associated with estimates of fetal and maternal health, women who later developed GH (n=50) or PreE (n=50) were compared with body mass index-matched controls (n=100). Women who subsequently developed PreE or GH had increased Ang-(1-7) levels at 15 weeks' gestation compared with women with normal pregnancies. When separated by fetal sex, this difference was seen only in women carrying a female fetus. Prorenin and ACE concentrations were not useful biomarkers for the prediction of either PreE or GH at 15 weeks' gestation. Women with a male fetus who developed PreE and women who subsequently developed GH had increased blood pressures at 15 weeks' gestation compared with women with normal pregnancies, suggesting that these women were on an early trajectory for the development of hypertension. We propose that measurement of Ang-(1-7) during early gestation could be useful in predicting, those women who will go on to develop new-onset hypertension in pregnancy.
authors.affiliation: 1] Mothers and Babies Research Centre, Hunter Medical Research Institute, University of Newcastle, New Lambton Heights, NSW, Australia [2] Robinson Institute, University of Adelaide, Adelaide, SA, Australia.
authors.forename: S D
authors.initials: SD
authors.lastname: Sykes
authors.affiliation: Mothers and Babies Research Centre, Hunter Medical Research Institute, University of Newcastle, New Lambton Heights, NSW, Australia.
authors.forename: K G
authors.initials: KG
authors.lastname: Pringle
authors.affiliation: Robinson Institute, University of Adelaide, Adelaide, SA, Australia.
authors.forename: A
authors.initials: A
authors.lastname: Zhou
authors.affiliation: 1] Robinson Institute, University of Adelaide, Adelaide, SA, Australia [2] Women's and Children's Division, Lyell McEwin Hospital, SA, Australia.
authors.forename: G A
authors.initials: GA
authors.lastname: Dekker
authors.affiliation: Robinson Institute, University of Adelaide, Adelaide, SA, Australia.
authors.forename: C T
authors.initials: CT
authors.lastname: Roberts
authors.affiliation: Mothers and Babies Research Centre, Hunter Medical Research Institute, University of Newcastle, New Lambton Heights, NSW, Australia.
authors.forename: E R
authors.initials: ER
authors.lastname: Lumbers
mesh_terms: D000328:Adult; D000803:Angiotensin I / Q000097:blood; D000804:Angiotensin II / Q000097:blood; D015415:Biomarkers / Q000097:blood; D001794:Blood Pressure; D016022:Case-Control Studies; D005260:Female; D005865:Gestational Age; D006801:Humans; D046110:Hypertension, Pregnancy-Induced / Q000097:blood / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D008297:Male; D010446:Peptide Fragments / Q000097:blood; D007703:Peptidyl-Dipeptidase A / Q000097:blood; D011225:Pre-Eclampsia / Q000097:blood / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D011247:Pregnancy; D012083:Renin / Q000097:blood; D012084:Renin-Angiotensin System; D018570:Risk Assessment; D012307:Risk Factors; D012732:Sex Determination Analysis; D012737:Sex Factors; D018608:Ultrasonography, Doppler; D016216:Ultrasonography, Prenatal; D055815:Young Adult
chemical_list: D015415:Biomarkers; D010446:Peptide Fragments; D000804:Angiotensin II; D000803:Angiotensin I; C488034:ACE protein, human; D007703:Peptidyl-Dipeptidase A; D012083:Renin; C118790:angiotensin I (1-7)