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Increased Risk of Preeclampsia in Women With a Genetic Predisposition to Elevated Blood Pressure
Anna Kivioja1,2, Elli Toivonen1,2, Jaakko Tyrmi2,3,4,5
1Department of Obstetrics and Gynecology, Tampere University Hospital, Finland (A.K., E.T., H.L.).
Insights
High genetic risk for blood pressure is linked to increased preeclampsia risk and severity. This finding highlights the role of blood pressure regulation genes in preeclampsia development.
Area of Science:
- Obstetrics and Gynecology
- Genetics
- Cardiovascular Disease
Background:
- Preeclampsia is a significant cause of maternal and perinatal morbidity.
- Genetic factors are implicated in the onset of preeclampsia.
- Understanding genetic predispositions is crucial for predicting and managing preeclampsia.
Purpose of the Study:
- To investigate the association between the polygenic risk score for blood pressure (BP-PRS) and preeclampsia.
- To examine the relationship between BP-PRS and preeclampsia subtypes, including recurrent and severe forms.
- To assess the impact of BP-PRS on blood pressure levels during pregnancy.
Main Methods:
- Analysis of the FINNPEC study cohort (1514 preeclamptic, 983 control women).
- Case-control setting comparing women with high BP-PRS (>95th percentile) and low BP-PRS (≤5th percentile).
- Evaluation of BP-PRS effect on blood pressure across preeclamptic, hypertensive control, and normotensive control cohorts.
Main Results:
- Women with high BP-PRS exhibited higher blood pressure throughout pregnancy.
- Preeclampsia was more frequent in women with high BP-PRS (71.8%) compared to others (60.1%).
- High BP-PRS was associated with an increased risk of preeclampsia (OR, 1.7) and more frequent presentation of recurrent and severe preeclampsia.
Conclusions:
- High BP-PRS is associated with an elevated risk of preeclampsia, including recurrent and severe forms.
- Elevated blood pressure during pregnancy is linked to high BP-PRS.
- These findings underscore the role of genetic variants in blood pressure regulation in the etiology of preeclampsia, particularly severe cases.
Background:
Preeclampsia causes significant maternal and perinatal morbidity. Genetic factors seem to affect the onset of the disease. We aimed to investigate whether the polygenic risk score for blood pressure (BP; BP-PRS) is associated with preeclampsia, its subtypes, and BP values during pregnancy.
Methods:
The analyses were performed in the FINNPEC study (Finnish Genetics of Pre-Eclampsia Consortium) cohort of 1514 preeclamptic and 983 control women. In a case-control setting, the data were divided into percentiles to compare women with high BP-PRS (HBP-PRS; >95th percentile) or low BP-PRS (≤5th percentile) to others. Furthermore, to evaluate the effect of BP-PRS on BP, we studied 3 cohorts: women with preeclampsia, hypertensive controls, and normotensive controls.
Results:
BP values were higher in women with HBP-PRS throughout the pregnancy. Preeclampsia was more common in women with HBP-PRS compared with others (71.8% and 60.1%, respectively; P=0.009), and women with low BP-PRS presented with preeclampsia less frequently than others (44.8% and 61.5%, respectively; P<0.001). HBP-PRS was associated with an increased risk for preeclampsia (odds ratio, 1.7 [95% CI, 1.1-2.5]). Furthermore, women with HBP-PRS presented with recurrent preeclampsia and preeclampsia with severe features more often.
Conclusions:
Our results suggest that HBP-PRS is associated with an increased risk of preeclampsia, recurrent preeclampsia, and preeclampsia with severe features. Furthermore, women with HBP-PRS present higher BP values during pregnancy. The results strengthen the evidence pointing toward the role of genetic variants associated with BP regulation in the etiology of preeclampsia, especially its more severe forms.
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