Objective Preeclampsia (preE) is a multifaceted complication found uniquely in the pregnant patient and one that has puzzled scientist for years. It has been demonstrated that preE is not a single disorder, but a complex syndrome that is produced by various pathophysiologic triggers and mechanisms affecting 3–8% of obstetrical patients worldwide. PreE, is a major cause of premature delivery and maternal and fetal death. It is characterized by de novo development of hypertension and proteinuria after 20 weeks gestation. preE has a significant link to alterations of placental function leading to stress and apoptotic signaling, which pass the placental barrier and leave persistent defect in the circulation of the offspring. We assessed the comparison of pregnancy outcome between patients with and without preE.
Methods We recruited 20 normal pregnant (NP) and 20 preE consenting patients after deliveries in an IRB approved prospective study from Scott & White Healthcare. We evaluated the following parameters for mothers BP, Proteinuria, BMI, Gestational age, Age, Placental factors: circumference, placental signaling proteins. The placental stress signaling proteins (p38 MAPK, COX-2 and Bax/Bcl-2) were measured. We also evaluated babies for IUGR and anthropometric measurements. Comparisons were performed using Student's t test.
Results Mothers in the PE group had significantly higher blood pressures (SBP p=0.0000001 and DBP p=0.001) and also higher urinary protein excretion (p=0.002). Average hospital stay for PreE babies were longer than NP babies (p=0.001879). No complications were reported for NP babies; however, preE babies had multiple complications like hypoglycemia, RDS etc though they were born at preterm. Many of the PreE babies were born premature (p=0.017). The birth weights of the PE babies were much lower than the NP babies with a p value of 0.027 and also the PE babies were significantly SGA when compare to the NP babies with significant difference in their Ponderal Index (PI) (p=0.0004). The placental stress signaling proteins p38 MAPK, COX-2 and Bax/Bcl-2 were up-regulated in preE compared to normal pregnancy (p<0.05, in each case).
Conclusions PreE alters the intrauterine environment and activates the detrimental signaling that is transported to fetus resulting in premature deliveries, IUGR babies and their related complications like extended hospitalization.
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