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The REVAMP study: research exploring various aspects and mechanisms in preeclampsia: study protocol
Nisha S Wadhwani1, Deepali P Sundrani1, Girija N Wagh2
1Mother and Child Health, Interactive Research School for Health Affairs (IRSHA), Bharati Vidyapeeth (Deemed to be University), Pune Satara Road, Pune, 411043, India.
Insights
This study investigates how maternal long-chain polyunsaturated fatty acids (LCPUFA) impact preeclampsia risk and outcomes. Findings will aid in early risk identification and understanding developmental programming in children.
Area of Science:
- Obstetrics and Gynecology
- Nutritional Science
- Developmental Biology
Background:
- Preeclampsia poses significant risks to maternal and infant health globally.
- Understanding preeclampsia etiology is crucial for effective prevention and treatment.
- Dietary long-chain polyunsaturated fatty acids (LCPUFA) are implicated in pathways relevant to preeclampsia.
Purpose of the Study:
- To longitudinally examine the association between maternal LCPUFA levels and preeclampsia outcomes.
- To investigate the role of LCPUFA in the biochemical and molecular mechanisms of preeclampsia.
- To explore the relationship between LCPUFA, preeclampsia, and developmental programming in children.
Main Methods:
- The REVAMP study prospectively follows a cohort of pregnant women from early gestation to delivery.
- Data collection includes personal, obstetric, clinical history, anthropometry, FFQ, physical activity, and socioeconomic status.
- Biological samples (maternal blood, cord blood, placenta) are collected and stored for analysis. Fetal and infant assessments are conducted up to age 2.
Main Results:
- Data collection and sample acquisition are ongoing.
- Analysis will focus on associations between LCPUFA and preeclampsia development and severity.
- Further analysis will explore LCPUFA's role in fetal development and long-term child outcomes.
Conclusions:
- This research aims to facilitate early identification of women at risk for preeclampsia.
- The study will elucidate the role of LCPUFA in preeclampsia pathogenesis and its impact on child development.
- Findings are expected to inform potential dietary interventions for preeclampsia prevention.
Background:
Preeclampsia is a major cause of maternal, fetal and neonatal morbidity and mortality, particularly in developing countries. Considering the burden of preeclampsia and its associated complications, it is important to understand the underlying risk factors and mechanisms involved in its etiology. There is considerable interest in the potential for dietary long chain polyunsaturated fatty acids (LCPUFA) as a therapeutic intervention to prevent preeclampsia, as they are involved in angiogenesis, oxidative stress, and inflammatory pathways.
Methods:
The REVAMP study (Research Exploring Various Aspects and Mechanisms in Preeclampsia) follows a cohort of pregnant women from early pregnancy until delivery to examine longitudinally the associations of maternal LCPUFA with clinical outcome in preeclampsia. A multisite centre for advanced research was established and pregnant women coming to Bharati hospital and Gupte hospital, Pune, India for their first antenatal visit are recruited and followed up at 11-14 weeks, 18-22 weeks, 26-28 weeks, and at delivery. Their personal, obstetric, clinical, and family history are recorded. Anthropometric measures (height, weight), food frequency questionnaire (FFQ), physical activity, socioeconomic status, fetal ultrasonography, and color Doppler measures are recorded at different time points across gestation. Maternal blood at all time points, cord blood, and placenta at delivery are collected, processed and stored at - 80 °C. The children's anthropometry is assessed serially up to the age of 2 years, when their neurodevelopmental scores will be assessed.
Discussion:
This study will help in early identification of pregnant women who are at risk of developing preeclampsia. The prospective design of the study for the first time will establish the role of LCPUFA in understanding the underlying biochemical and molecular mechanisms involved in preeclampsia and their association with developmental programming in children.
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