title: Early-pregnancy asymmetric dimethylarginine (ADMA) levels in women prone to develop recurrent hypertension.
abstract: OBJECTIVE
  To evaluate early-pregnancy levels of ADMA (asymmetric dimethylarginine) in recurrent hypertensive pregnancy.
  
  
  METHODS
  In this retrospective observational study, blood samples from 35 normotensive women with a previous hypertensive pregnancy were obtained preconceptionally and at 12, 16 and 20weeks in their next pregnancy. We assessed ADMA, symmetric dimethylarginine (SDMA), l-arginine and l-citrulline. We analyzed differences in longitudinal patterns between normotensive (NT, n=18) and recurrent hypertensive (HT, n=17) pregnancies by linear mixed models, with a sub-analysis for preeclampsia (PE, n=6).
  
  
  METHODS
  ADMA, SDMA, l-arginine and l-citrulline.
  
  
  RESULTS
  Pre-pregnant SDMA and l-citrulline were lower in HT. At 12weeks, ADMA and ADMA/SDMA ratio correlated inversely with PAPP-A and β-hCG, respectively. In both groups, ADMA-related compounds changed inconsistently with advancing (mid-trimester) pregnancy, although in HT, l-arginine tended to decrease between 16 and 20weeks, a decline consistent in PE.
  
  
  CONCLUSIONS
  These data support a modest role for ADMA and related metabolites in the pathogenesis of hypertensive pregnancy.
authors.affiliation: Department of Obstetrics and Gynecology, Maastricht University Medical Centre, P.O. Box 5800, 6202 AZ Maastricht, The Netherlands. Electronic address: carmen.rijvers@maastrichtuniversity.nl.
authors.forename: C A H
authors.initials: CA
authors.lastname: Rijvers
authors.affiliation: Department of Obstetrics and Gynecology, Universita La Sapienza, 00185 Rome, Italy. Electronic address: sara1081@inwind.it.
authors.forename: S
authors.initials: S
authors.lastname: Marzano
authors.affiliation: Department of Methodology and Statistics, Maastricht University Medical Centre, P.O. Box 5800, 6202 AZ Maastricht, The Netherlands. Electronic address: bjorn.winkens@maastrichtuniversity.nl.
authors.forename: B
authors.initials: B
authors.lastname: Winkens
authors.affiliation: Department of Clinical Genetics, Maastricht University Medical Centre, P.O. Box 5800, 6202 AZ Maastricht, The Netherlands. Electronic address: jaap.bakker@mumc.nl.
authors.forename: J A
authors.initials: JA
authors.lastname: Bakker
authors.affiliation: Department of Internal Medicine, Maastricht University Medical Centre, P.O. Box 5800, 6202 AZ Maastricht, The Netherlands. Electronic address: aa.kroon@mumc.nl.
authors.forename: A A
authors.initials: AA
authors.lastname: Kroon
authors.affiliation: Department of Obstetrics and Gynecology, Maastricht University Medical Centre, P.O. Box 5800, 6202 AZ Maastricht, The Netherlands. Electronic address: marc.spaanderman@mumc.nl.
authors.forename: M E A
authors.initials: ME
authors.lastname: Spaanderman
authors.affiliation: Department of Obstetrics and Gynecology, Maastricht University Medical Centre, P.O. Box 5800, 6202 AZ Maastricht, The Netherlands. Electronic address: l.l.h.peeters@umcutrecht.nl.
authors.forename: L L H
authors.initials: LL
authors.lastname: Peeters
keywords: ADMA; Gestational hypertension; Longitudinal; Preeclampsia; Recurrent