Cardiovascular risk assessment in women at high risk for pre-eclampsia in first half of pregnancy
Ullmo, Johana (Universitat Autònoma de Barcelona. Departament de Pediatria, Obstetrícia i Ginecologia i de Medicina Preventiva i Salut Pública)
Cruz-Lemini, Monica (Institut de Recerca Sant Pau)
Bos-Real, L (Hospital de la Santa Creu i Sant Pau (Barcelona, Catalunya))
Padilla-Lopez, Mireia (Hospital de la Santa Creu i Sant Pau (Barcelona, Catalunya))
Coma-Barbarà, Marina (Hospital de la Santa Creu i Sant Pau (Barcelona, Catalunya))
Martorell, Silvia (Hospital de la Santa Creu i Sant Pau (Barcelona, Catalunya))
Mora, Josefina (Institut de Recerca Sant Pau)
Ordóñez, J. (Jordi) 1952- (Institut de Recerca Sant Pau)
Llurba, E (Universitat Autònoma de Barcelona. Departament de Pediatria, Obstetrícia i Ginecologia i de Medicina Preventiva i Salut Pública)

Date:	2025
Abstract:	Background: Women diagnosed with pre-eclampsia (PE), especially those with early-onset and severe forms, are at heightened risk of future cardiovascular disease (CVD). It is uncertain if women at high-risk for PE present cardiovascular impairment at the beginning of pregnancy. The aim of this study was to assess cardiovascular biomarkers and cardiac function in the first half of pregnancy in women at high-risk for PE. Methods: This was a prospective cohort study including women attending first trimester screening for PE. Risk of PE in the first trimester was calculated using a previously validated model, which includes maternal factors and biophysical markers. A cut-off of 1 in 250 was used to classify high-risk for developing PE. Maternal echocardiographic function and morphometry were evaluated, and peripheral blood samples were obtained to assess hematological and biochemical variables, including lipid profile and cardiovascular and angiogenic factors. Results: A total of 349 pregnant individuals were included; 257 at high-risk and 92 at low-risk for PE. Maternal echocardiography was performed at a mean ± SD gestational age of 14. 9 ± 1. 3 weeks and blood sampling at 16. 3 ± 1. 9 weeks. The high-risk PE group exhibited a significantly worse lipid profile (lower levels of high-density lipoproteins 69. 7 ± 14. 2 vs 74. 0 ± 14. 6 mg/dL, p=0. 020), lower placental growth factor (0. 89 ± 0. 63 vs 1. 15 ± 0. 58 MoM, p<0. 001), and significantly lower levels of N-terminal pro-brain natriuretic peptide (51. 0 ± 2. 1 vs 52. 1 ± 2. 0 ng/L, p=0. 008). Echocardiographic evaluation indicated concentric remodeling, along with an altered diastolic pattern in the high-risk group. Conclusions: Women at high risk of developing PE exhibit differences in lipid profile, angiogenic factors, and echocardiographic parameters, indicative of cardiac maladaptation or impairment during the first half of pregnancy. These findings suggest a link between subclinical cardiovascular dysfunction, PE development and later CVD risk.
Grants:	Instituto de Salud Carlos III PI19/00702 Ministerio de Economía y Competitividad RD16/0022/0015 Ministerio de Economía y Competitividad PT13/0002/0028 Instituto de Salud Carlos III RD21/0012/0001
Note:	Altres ajuts: Juan Rodés contract (JR19/00047)
Rights:	Aquest material està protegit per drets d'autor i/o drets afins. Podeu utilitzar aquest material en funció del que permet la legislació de drets d'autor i drets afins d'aplicació al vostre cas. Per a d'altres usos heu d'obtenir permís del(s) titular(s) de drets.
Language:	Anglès
Document:	Article ; recerca ; Versió acceptada per publicar
Subject:	Pre-eclampsia ; Angiogenic factors ; Echocardiography ; Cardiovascular risk ; Cardiac biomarkers
Published in:	Ultrasound in obstetrics & gynecology, 2025 , ISSN 1469-0705

Available from: 2099-01-01

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Research literature > UAB research groups literature > Research Centres and Groups (research output) > Health sciences and biosciences > Institut de Recerca Sant Pau
Articles > Research articles
Articles > Published articles