Predisposition to superimposed preeclampsia in women with chronic hypertension: endothelial, renal, cardiac, and placental factors in a prospective longitudinal cohort

ABSTRACT

Objective

To assess the contribution of maternal and placental factors to the development of superimposed preeclampsia in women with chronic hypertension.

Methods

Endothelial and renal function markers were serially assessed in 90 pregnant women with chronic hypertension and controls.

Results

Syndecan-1 concentrations were lower at 26–27⁺⁶ weeks in women with chronic hypertension who subsequently developed superimposed preeclampsia compared with those who did not. Decreased PlGF and raised urine albumin:creatinine ratio were also associated with development of superimposed preeclampsia.

Conclusion

Decreased syndecan-1 and PlGF concentrations implicate endothelial glycocalyx disturbance and reduced placental angiogenic capacity, respectively, in the pathophysiology of superimposed preeclampsia.

KEYWORDS:

• Chronic hypertension
• superimposed preeclampsia
• endothelium
• kidney
• placenta

Acknowledgments

We acknowledge the support of the Global Pregnancy Collaboration. The Global Pregnancy Collaboration is part of the Pre-eclampsia-Eclampsia Monitoring, Prevention & Treatment (PRE-EMPT) initiative funded by the University of British Columbia, a grantee of the Bill & Melinda Gates Foundation.

Disclosure statement

The authors report no conflict of interest.

Supplementary material

Supplemental data for this article can be accessed here.