The Adverse Impact of Pregestational Prediabetes Contributes to HELLP Syndrome Development

Area of Science:

• Obstetrics and Gynecology
• Endocrinology
• Pathology

Background:

• Preeclampsia (PE) and prediabetes (PD) are hypertensive disorders of pregnancy with a known correlation.
• Previous research indicated pregestational PD increases antiangiogenic factors, a risk factor for PE.
• The association between pregestational PD, antiangiogenic factors, and liver dysfunction remained unclear.

Purpose of the Study:

• To investigate pregestational prediabetes (PD) as a risk factor for hemolysis, elevated liver enzymes, and low platelet (HELLP) syndrome.
• To determine if pregestational PD is linked to the metabolic and inflammatory changes seen in HELLP syndrome.

Main Methods:

• Animal models were divided into normal pregnant (ND), preeclamptic pregnant (PE), and prediabetic pregnant (PD) groups.
• On gestational day 19, blood and liver tissues were collected.
• Measurements included antioxidant protection, lipid peroxidation, liver triglycerides (TGs), liver enzymes, TNF-α, IL-6, and hematology parameters.

Main Results:

• The PE and PD groups showed significant increases in liver TGs, liver enzymes, TNF-α, and IL-6 compared to the ND group.
• Hematology parameters were also significantly altered in the PE and PD groups.
• These findings indicate metabolic and inflammatory disturbances in prediabetic and preeclamptic pregnancies.

Conclusions:

• Pregestational PD appears to predispose individuals to metabolic and inflammatory changes associated with HELLP syndrome.
• This is the first study to link pregestational PD to HELLP syndrome complications in a preclinical model.
• Monitoring pre-pregnancy metabolic health is crucial for preventing adverse pregnancy outcomes.