2006, Number 4
Perinatol Reprod Hum 2006; 20 (4)
Role of preeclampsia in clinical, anthropometric and biochemistry evolution in the first postpartum year
Pizano-Zárate ML, Ramírez-González MC, Mendoza-Flores ME, Tolentino-Dolores M, Morales-Hernández RM, Meza-Camacho C, Ávila-Rosas H
PDF size: 99.77 Kb.
Hypertension induced by pregnancy complicates between 5 to 10% of all pregnancies among Mexican women and represents the principal cause of maternal, fetal and neonatal morbimortality. Woman with a personal history of preeclam-psia (PE) have a higher risk to develop further hypertension and cardiovascular disease (CV). Among hypertensive disorders, metabolic syndrome and insulin resistance are suggested as etiologic factors.
To evaluate the role of PE among anthropometric, clinic and biochemical evolution during the first year postpartum.
Material and Methods:
A cohort study was performed with woman between 18 to 45 years, with a history PE in their last pregnancy who receives attention at the Instituto Nacional de Perinatología (INPerIER). The analyzed variables were the ones that are characteristic of the metabolic syndrome such as blood pressure, abdominal obesity, triglycerides, high density lipoprotein (HDL) and fasting plasma glucose. During the 1st year postpartum, the variables were measured three times, at three, six and 12 months. The control group had the same measurements and also the same characteristics than the other group, except for the presence of PE.
In the postpartum period, the history of PE is commonly related with higher blood pressure. Fat distribution, fasting plasma glucose, triglycerides and HDL neither change across time no changed when presence of previous PE.
Seeley EW, Solomon CG. Insulin resistance and its potential role in pregnancy-induced hypertension. J Clin Endocrinol Metab 2003; 88: 2393-8.
Diagnosis and management of preeclam-psia and eclampsia: ACOG practice bulletin no. 33: American College of Obstetricians and Gynecologists. Obstet Gynecol 2002; 99: 159-67.
National High Blood Pressure Education Program. Report of the National High Blood Pressure Education Program Wor-king Group on high blood pressure in pregnancy. Am J Obstet Gynecol 2000; 183: S1-S22.
Buhimschi CS, Magloire L, Funai E, et al. Fractional excretion of angiogenic factors in women with severe preeclampsia. Obstet Gynecol 2006; 107: 1103-13.
Gupta S, Agarwal A, Sharma RK. The role of placental oxidative stress and lipid peroxidation in preeclampsia. Obstet Gynecol Surv 2005; 60: 807-16.
Wolf M, Hubel CA, Lam C, et al. Pree-clampsia and future cardiovascular disease: potential role of altered angiogenesis and insulin resistance. J Clin Endocrinol Metab 2004; 89: 6339-43.
Avogadro P, Crepaldi G. First Annual Meeting of the European Association for the Study of Diabetes. Diabetología 1965; 1: 137 (Abs. 53).
Modan M, Halkin, Almong S, Lusky A, Eshkol A, Shefi M, et al. Hyperinsulinemia: a link between hypertension, obesity and glucose intolerance. J Clin Invest 1985; 75: 807-17.
Ferranini E, Buzzigoli E, Bonnadona. Insulin resistance in essential hypertension. N Engl J Med 1987; 317: 350.
Reaven GM. Role of insulin resistance in human disease. Diabetes 1988; 37: 1595-607.
Hnat MD, Sibai BM, Caritis S, et al. Prenatal outcome in women with recurrent pree-clampsia compared with women who develop preeclampsia as nulliparas. Am J Obstet Gynecol 2002; 186: 422-6.
Laivuori H, Tikkanen MJ, Ylikorkala O. Hyperinsulinemia 17 years after preeclam-psia first pregnancy. J Clin Endocrin Metabol 1996; 81: 2908-11.
Kaaja R, Laivuori H, Laakso M, Tikkanen MJ, Ylikorkala O. Evidence of a state of increased insulin resistance in preeclampsia. Metabolism 1999; 48: 892-6.
Hubel CA, Snaedal S, Ness RB, Weissfeld LA, Geirsson RT, Roberts JM, et al. Dyslipoproteinaemia in postmenopausal women with a history of eclampsia. Br J Obstet Gynecol 2000; 107: 776-84.