The Influence of Maternal Obesity on Cell-Free Fetal DNA and Blood Pressure Regulation in Pregnancies with Hypertensive Disorders

Background and Objectives: obesity and blood pressure disorders are one of the main risk factors for antenatal, intra, postpartum, and neonatal complications. In preeclampsia (PE), the placental hypoxia leads to vascular endothelium dysfunction, cell necrosis, and apoptosis. This condition is associated with the release of free fetal DNA (cffDNA) circulating in plasma. The disturbance of the efficiency of vasodilatation and blood pressure regulation in PE can be confirmed by analyzing the apelin, salusin, and prosalusin. This study aimed to assess the influence of obesity on cffDNA, and the effectiveness of maintaining normal blood pressure in patients with preeclampsia and gestational hypertension. Material and Methods: the research material was blood serum and oral mucosa swabs, obtained from 168 patients. Pregnant women were divided into the following: a control group (C)—67 women; a gestational hypertension group (GH)—35 patients; a preeclampsia with obesity group (PE + O) (pre-gravid BMI > 30)—23 patients. The rest were lean preeclamptic women (PE)—66 patients—(pre-gravid BMI < 25 in 43 women). Results: the cffDNA was observed in 1.50% of women in the C group, in 2.45% in the GH group, but in 18.18% of lean patients with preeclampsia. The cffDNA was detected in 58% of obese pregnant women with PE. The greater the placental hypoxia was in preeclampsia, the less efficient the hypotensive mechanisms, according to an analysis of the studied adipokines. The prosalusin concentration was significantly lower in the PE group with cffDNA than in the PE group without it (p = 0.008). Apelin was higher in the PE group with cffDNA (p = 0.006) compared to other groups. The same results were also observed in the subgroup with obesity. Conclusion: in preeclamptic women, obesity seems to act as an additive factor of placental damage by means of the dysregulation of hypotensive mechanisms.

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Spontaneous sustained pregnancy-associated hypertension in SHHF/Mcc-facp rats: a possible model for impaired blood pressure regulation in pregnant women

American Journal of Hypertension ◽

10.1016/s0895-7061(00)01024-4 ◽

2000 ◽

Vol 13 (6) ◽

pp. S277

Author(s):

L Sharkey

Keyword(s):

Blood Pressure ◽

Pregnant Women ◽

Blood Pressure Regulation ◽

Pressure Regulation

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Altered circulating Tregs and their functional cytokines in hypertensive patients with or without left ventricular hypertrophy

10.21203/rs.3.rs-847306/v1 ◽

2021 ◽

Author(s):

Ying Tang ◽

Li Shen ◽

Danyan Xu ◽

Jing-hui Bao

Keyword(s):

Blood Pressure ◽

Ventricular Hypertrophy ◽

Transforming Growth Factor ◽

Cell Subset ◽

Left Ventricular ◽

Blood Pressure Regulation ◽

Control Group ◽

Pressure Regulation ◽

Hypertensive Patients ◽

Tgf Β1

Abstract Background:Left ventricular hypertrophy (LVH) is the most common target organ damage in hypertension. In addition to the increased left ventricular afterload, immune injury participates in LVH pathogenesis. CD4+CD25+Foxp3+ regulatory T lymphocytes (Tregs) are a T cell subset with immunomodulatory effects; abnormal Treg numbers or functions can cause immune disorders. This study aimed to explore the role of Tregs in LVH by investigating circulating Tregs and associated cytokine levels in hypertensive patients with LVH.Methods:Blood samples were collected from 69 healthy individuals (control group, CG), 91 hypertensive patients with LVH (LVH group) and 83 hypertensive patients without LVH (essential hypertension, EH group). Circulating Tregs and associated cytokines were measured by flow cytometry and enzyme-linked immunosorbent assays, respectively.Results:Circulating Tregs were significantly lower in EH and LVH patients than in CG subjects. The circulating Treg level was lower in LVH patients than in EH patients. No correlation between blood pressure regulation and Treg levels was found in EH or LVH patients. Furthermore, circulating Tregs in postmenopausal females were lower than those in males among LVH patients. Additionally, serum IL-10 and transforming growth factor (TGF)-β1 were decreased in EH and LVH patients, and the serum IL-6 level was significantly increased in LVH patients. Circulating Tregs were negatively correlated with CK, LDL, apoB, high-sensitivity C-reactive protein and left ventricular mass index values.Conclusion:Our study is the first to demonstrate the significantly decreased circulating Treg proportion in LVH patients. The protective effect of Tregs in LVH is independent of blood pressure regulation. The functional Treg cytokines IL-6, IL-10 and TGF-β1 participate in this immunomodulatory process.Trial registration: The study was approved by the Institutional Medical Ethics Committee of the Second Xiangya Hospital of Central South University (2018/No.046).

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Maternal and fetal outcomes of obese pregnant women: a prospective cohort study

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20170413 ◽

2017 ◽

Vol 6 (2) ◽

pp. 725

Author(s):

Jenniferbritto John ◽

Mary Mahendran

Keyword(s):

Diabetes Mellitus ◽

Caesarean Section ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Pregnant Women ◽

Maternal Obesity ◽

Gestational Hypertension ◽

Induction Of Labour ◽

Control Group ◽

Fetal Outcomes

Background: Obesity in Indian women had increased from 10.6% to 14.8% in India. Mothers who are overweight or obese during pregnancy and childbirth cause significant antenatal, intrapartum, postpartum and also neonatal complications. The present study aimed to explore various maternal and fetal outcomes influenced by maternal obesity. The objective was to find the effect of obesity on maternal and perinatal outcome among obese pregnant women compared to those of normal weight.Methods: The study was conducted in antenatal women attending antenatal outpatient department of CSI rainy multispecialty hospital located in North Chennai of South India. Consecutive sampling method was followed to include 50 cases and 50 controls. Analysis was done with IBM SPSS v.21.0. Chi square test was applied to find difference between proportions. For comparison of means independent t-test and ANOVA was applied. Pearson's correlation was done to find association between maternal BMI and birth weight.Results: Sixteen (32%) cases developed gestational diabetes mellitus during their antenatal period and 19 (38%) developed gestational hypertension. 10% underwent in emergency caesarean section and in 28% cases elective caesarean section was done. The proportion of cases who developed ante partum complications including gestational diabetes mellitus, gestational hypertension and preeclampsia were higher than in control groups (p value = 0.03,0.00,0.004 respectively). The need for induction of labour and caesarean section was found to be higher in cases than in controls (p = 0.014,0.03 respectively). Increased NICU admissions for stabilization of the newborn among cases was higher than control group (p = 0.012).Conclusions: It was clearly evident from the present study that maternal obesity had adverse maternal and fetal outcomes. Maternal obesity was strongly associated with antenatal complications like gestational diabetes mellitus, gestational hypertension, preeclampsia and increase in need for induction of labour and operative interference.

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Mechanisms of blood pressure regulation that differ in men repeatedly exposed to high-G acceleration

AJP Regulatory Integrative and Comparative Physiology ◽

10.1152/ajpregu.2001.280.4.r947 ◽

2001 ◽

Vol 280 (4) ◽

pp. R947-R958 ◽

Cited By ~ 15

Author(s):

Victor A. Convertino

Keyword(s):

Blood Pressure ◽

Lower Body Negative Pressure ◽

Venous Pressure ◽

Blood Pressure Regulation ◽

Control Group ◽

Pressure Regulation ◽

Total Blood ◽

Trained Subjects ◽

Arterial Blood ◽

Baroreceptor Stimulation

The purpose of this study was to test the hypothesis that repeated exposure to high acceleration (G) would be associated with enhanced functions of specific mechanisms of blood pressure regulation. We measured heart rate (HR), stroke volume (SV), cardiac output (Q̊), mean arterial blood pressure, central venous pressure, forearm and leg vascular resistance, catecholamines, and changes in leg volume (%ΔLV) during various protocols of lower body negative pressure (LBNP), carotid stimulation, and infusions of adrenoreceptor agonists in 10 males after three training sessions on different days over a period of 5–7 days using a human centrifuge (G trained). These responses were compared with the same measurements in 10 males who were matched for height, weight, and fitness but did not undergo G training (controls). Compared with the control group, G-trained subjects demonstrated greater R-R interval response to equal carotid baroreceptor stimulation (7.3 ± 1.2 vs. 3.9 ± 0.4 ms/mmHg, P = 0.02), less vasoconstriction to equal low-pressure baroreceptor stimulation (−1.4 ± 0.2 vs. −2.6 ± 0.3 U/mmHg, P = 0.01), and higher HR (−1.2 ± 0.2 vs. −0.5 ± 0.1 beats · min−1 · mmHg−1, P = 0.01) and α-adrenoreceptor response (32.8 ± 3.4 vs. 19.5 ± 4.7 U/mmHg, P = 0.04) to equal dose of phenylephrine. During graded LBNP, G-trained subjects had less decline in Q̊ and SV, %ΔLV, and elevation in thoracic impedance. G-trained subjects also had greater total blood (6,497 ± 496 vs. 5,438 ± 228 ml, P = 0.07) and erythrocyte (3,110 ± 364 vs. 2,310 ± 96 ml, P = 0.06) volumes. These results support the hypothesis that exposure to repeated high G is associated with increased capacities of mechanisms that underlie blood pressure regulation.

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