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Cohort profile: The PreEclampsia, Angiogenesis, Cardiac dysfunction and Hypertension (PEACH) Study
Lisa Kristine Grange Persson1,2, Frederikke Fog Lihme1, Saima Basit1
1Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark.
Insights
The PEACH Study aims to identify new subtypes of hypertensive disorders of pregnancy (HDP) and markers for future cardiovascular disease risk. This research will improve monitoring and treatment for pregnant women with HDP.
Area of Science:
- Obstetrics and Gynecology
- Cardiovascular Health
- Perinatal Medicine
Background:
- Hypertensive disorders of pregnancy (HDP) are a major cause of maternal mortality globally.
- Preeclampsia, a common HDP, likely comprises multiple distinct subtypes with varying etiologies and prognoses.
- HDP poses risks for both maternal and neonatal well-being and long-term cardiovascular health.
Purpose of the Study:
- To establish novel subtyping systems for HDP based on etiology and prognosis.
- To identify biomarkers associated with later cardiovascular disease risk in women with preeclampsia.
- To understand the long-term cardiovascular health implications of HDP.
Main Methods:
- The PEACH Study is a prospective, longitudinal pregnancy cohort study.
- Recruitment involved pregnant women with suspected preeclampsia and healthy controls at two Copenhagen hospitals.
- Data collection included third-trimester blood and placental samples, repeated cardiac function assessments (USCOM-1A), and medical record abstraction.
Main Results:
- 1149 pregnant women were recruited between 2016-2018.
- Among 691 women with suspected preeclampsia, 310 developed preeclampsia and 172 developed gestational hypertension.
- Of 410 healthy controls, 37 later developed HDP; 53.1% participated in 1-year postpartum follow-up.
Conclusions:
- The PEACH Study's data will facilitate the identification of clinically useful HDP subtypes for improved management.
- Postpartum follow-up data will aid in developing algorithms to predict persistent cardiac dysfunction and future cardiovascular disease risk.
- This research aims to enhance long-term cardiovascular health outcomes for women affected by HDP.
Background:
Hypertensive disorders of pregnancy (HDP) remain a leading cause of maternal morbidity and mortality worldwide, with implications for maternal and neonatal well-being in the short term and for long-term maternal cardiovascular health. Although the mechanisms behind HDP remain incompletely understood, evidence suggests that preeclampsia in particular is a syndrome with more than one distinct subtype.
Objectives:
The PEACH (PreEclampsia, Angiogenesis, Cardiac dysfunction, Hypertension) Study was established to identify new HDP subtyping systems reflecting aetiology and prognosis and to find markers of later cardiovascular disease risk associated with preeclampsia.
Population:
The PEACH Study recruited pregnant women referred to two Copenhagen-area hospitals with suspected preeclampsia (mean gestational age at enrolment: 36.7 weeks) and a group of frequency-matched pregnant women planning delivery at the same hospitals and healthy when enrolled mid-pregnancy.
Design:
Prospective, longitudinal pregnancy cohort.
Methods:
Participants underwent repeated third-trimester blood sample collection, longitudinal cardiac function assessments using the USCOM-1A during the third trimester and at 1 year postpartum and collection of placental samples immediately after delivery. Medical information was abstracted from medical records and hospital databases.
Preliminary Results:
During 2016-2018, we recruited 1149 pregnant women, of whom 1101 were followed to delivery. Among 691 women enrolled with suspected preeclampsia, 310 and 172 developed preeclampsia and gestational hypertension respectively. Among 410 women with healthy pregnancies when enrolled mid-pregnancy, 37 later developed hypertensive disorders of pregnancy. Of 1089 women still in the cohort 1 year postpartum, 578 (53.1%) participated in the follow-up assessment.
Conclusions:
The PEACH Study's rich data from women with and without HDP will enable us to identify new, clinically useful HDP subtypes to aid in decision-making regarding monitoring and treatment. Continued postpartum follow-up will help us develop algorithms to identify women at risk of persistent postpartum cardiac dysfunction and later cardiovascular disease after pregnancies complicated by HDP.
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