Pregnant women with preeclampsia, diabetes need biomarkers checked

By Piriya Mahendra

Researchers are calling for cardiovascular (CV) biomarker profiling in pregnant women with preeclampsia and diabetes to help predict their future CV disease (CVD) risk.

Anne Staff (Oslo University Hospital, Norway) and team found that women whose pregnancies were complicated by Type 2 diabetes had different CV biomarker profiles to those whose pregnancies were complicated by preeclampsia, although both groups have an increased risk for CVD later in life.

They say that CV biomarker profiling may therefore be able to identify women at risk for future CVD, enabling targeted prophylactic interventions and follow up.

The analysis, reported in Pregnancy Hypertension, demonstrated that median levels of plasma mid-regional proatrial natriuretic peptide (MR-proANP) were significantly lower in pregnant women with diabetes than in women with healthy pregnancies (41 vs 56 pmol/L).

However, median MR-proANP levels were significantly higher in women whose pregnancies were complicated by diabetes and preeclampsia, than in pregnant women who had diabetes only (95 vs 41 pmol/L).

Levels of neopterin were higher in both women with diabetes and those with late-onset preeclampsia (from gestational week 37 onwards), compared with women who had healthy pregnancies (11.3 and 10.2 vs 9.1 nmol/L, respectively).

Median levels of plasma MR pro-adrenomedullin (MR-proADM) were also higher in pregnancies complicated by gestational diabetes or preeclampsia, compared with healthy pregnancies (1.34 and 1.31 vs 1.15 mol/L).

"Despite a similar increased risk for CVD later in life, the CV biomarker profile in pregnancies complicated by diabetes differed substantially from the one observed in preeclampsia," comment the authors. "This difference was somewhat attenuated when diabetic pregnancies were further complicated by preeclampsia."

They add: "Longitudinal studies are needed to conclude whether a CV biomarker profiling during pregnancy is helpful in targeting women at risk in order to implement prophylactic measures for future CVD."

The researchers obtained ethylenediamine tetra-acetic acid plasma measurements from 262 women in gestation week 24‑42 of a singleton pregnancy. Of these, 71 had healthy pregnancies, 105 had preeclampsia, 17 had Type 2 diabetes, 61 had gestational diabetes, and eight had diabetes with preeclampsia.

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