ArticleAmerican journal of obstetrics and gynecology2025
Prepregnancy physiology and subsequent preterm preeclampsia.
Article in American journal of obstetrics and gynecology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.
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Who cites it
10 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Preeclampsia and its relationship to pathological brain aging.Frontiers in physiology · 2022Pooled it
- Article
- Endothelial Dysfunction in Preeclampsia: Focus on the Uteroplacental Circulation.Arteriosclerosis, thrombosis, and vascular biology · 2026Review
- Preconception cardiac rehabilitation: a structured narrative review and conceptual framework for maternal cardiovascular health and fetal growth.Frontiers in medicine · 2026Review
- CRP-triglyceride-glucose index (CTGI) as a predictor of preeclampsia: a population-based study of risk stratification.Lipids in health and disease · 2025Article
- Development and validation of a novel prediction model for hypertensive disorders of pregnancy based on maternal cardiovascular function and placental blood flow metrics at 22 to 24 gestational weeks using machine learning.Scientific reports · 2025Article
- Prediction of preeclampsia before 11AJOG global reports · 2025Article
- Association of Periconceptional Dietary Inflammatory Index and Hypertensive Disorders of Pregnancy and Its Subtype.American journal of reproductive immunology (New York, N.Y. : 1989) · 2025Observational
- Causal Associations Between Pre-Pregnancy Diabetes Mellitus and Pre-Eclampsia Risk: Insights from a Mendelian Randomization Study.Healthcare (Basel, Switzerland) · 2025Article
- Understanding a Potential Role for the NLRP3 Inflammasome in Placenta-Mediated Pregnancy Complications.American journal of reproductive immunology (New York, N.Y. : 1989) · 2025Review
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3 authors.
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Abstract
backgroundPreeclampsia is a common pregnancy complication with debated etiology.
objectiveTo evaluate the contribution of prepregnancy physiology, biochemistry, and anthropometrics to the subsequent development of preterm preeclampsia. STUDY
designOne hundred twenty-four participants were recruited through open recruitment and targeted mailings. Participants included 81 nulliparous women and 43 with a history of preterm preeclampsia. We characterized cardiovascular function, metabolic profile, and body composition in 100 nonpregnant women who went on to subsequent pregnancy. Measures included plasma volume, baseline cardiovascular function and cardiovascular response to volume challenge, body composition, and circulating biochemical measures. Pregnancy outcome was obtained through chart review. Prepregnancy metrics for women who developed preterm preeclampsia were compared with measurements for those who did not, with adjustment for a history of prior preterm preeclampsia. Logistic regression modeling was used to identify the strongest prepregnancy factors associated with preterm preeclampsia.
resultsPregnancy outcomes included 11 women with preterm preeclampsia, 7 women with term preeclampsia, 20 women with other hypertension affecting their pregnancy, and 62 with uncomplicated pregnancies. We observed no difference in maternal age, study cycle day, lean body mass, uterine hemodynamics, or flow-mediated dilation across groups. Women with preterm preeclampsia had greater android fat content 3215±1143 vs 1918±1510 g (P=.002), faster supine pulse, 77±7 vs 67±10 beats per minute (P=.001), higher supine diastolic blood pressure 82±6 vs 68±6 mmHg (P<.001), increased cardiac output 5.6±1.1 vs 4.6±1 L/min (P=.002), faster aortic-popliteal pulse wave velocity 4.5±0.7 vs 3.8±0.5 m/sec (P<.001), and exaggerated cardiac output response to volume challenge 20±9 vs 9±12 L/min (P=.002) compared to those with other pregnancy outcomes. Women who developed preterm preeclampsia also had reduced renal vascular resistance index 0.86±0.08 vs 0.97±0.12 (P=.005) compared with other pregnancy outcomes when assessed prior to pregnancy. Women with subsequent preterm preeclampsia had higher serum c-reactive protein 10.7±12.5 vs 4.1±5.8 mg/mL (P=.003) and greater insulin resistance, as assessed by Homeostatic Model Assessment for Insulin Resistance calculation 2.2±1.1 vs 1.2±0.9 (P<.001).
conclusionPrepregnancy physiology is linked to subsequent preterm preeclampsia. The same factors associated with metabolic syndrome are more prominent in patients who develop preterm preeclampsia than those who do not, including increased vessel stiffness, low vascular compliance, high cardiac output, reduced renal vascular resistance index, insulin resistance, and increased android fat, all consistent with subclinical features of the metabolic syndrome.
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