Mohammad N. Uddin from the Scott & White Healthcare Department of Obstetrics and Gynecology at Texas A&M Health Science Center College of Medicine presented new work on preeclampsia during the Experimental Biology 2014 Meeting’s Cell Signaling poster session in San Diego. Preeclampsia is a syndrome in which pregnant women develop high blood pressure and protein in the urine during the late stages of pregnancy, which can lead to premature delivery and sometimes maternal and fetal death.
76,000 maternal and 500,000 infant deaths worldwide are attributed to preeclampsia, according to the Preeclampsia Foundation. Limited treatments are available, but the syndrome goes away naturally after the birth of the child.
Although preeclampsia is the most common complication of pregnancy, affecting 5% of pregnant women, its cause is unknown. “Preeclampsia is a multifaceted complication found uniquely in the pregnant patient and one that has puzzled scientists for years,” said Dr. Uddin. To tackle the issue at hand, Dr. Uddin’s laboratory focused on the molecular signals that occur during pregnancy to sustain the life of the developing fetus. Specifically, they looked at inhibitory signals that might be dysfunctional in preeclampsia.
Dr. Uddin’s team of scientists collected placentas and umbilical cords from 10 women with and 10 women without preeclampsia and compared protein expression between the groups. “Stress and apoptosis signaling was upregulated in preeclamptic placentas and umbilical cords compared with normal pregnancies,” concluded Dr. Uddin. Molecules related to stress (p38 MAPK), inflammation (Cox2), and apoptosis (Bax/Bcl-2 ratio) were increased in preeclampsia patients 3.0-fold, 2.5-fold, and 1.4-fold, respectively. Detrimental signaling is able to cross the placental barrier into the fetus, which then must adapt to its environment. Further, the imbalanced signaling reduces nutrient transport to the fetus.
The results of the study may explain the fate of the preeclampsia babies: hospital stays were an average of three days longer for preeclampsia babies compared to normal, and complications including low blood sugar, jaundice, respiratory distress syndrome, extra and fused digits, and abdominal fluid accumulation were present in the preeclampsia babies. These symptoms go hand-in-hand with the already well-known effects of preeclampsia on babies. According to Dr. Uddin, “These long-term effects are increased risk of hypertension and type 2 diabetes mellitus, aortic wall thickening, increased risk of stroke, intellectual disabilities, hearing disabilities, neurodevelopmental delay, cerebral palsy, and an increased risk of metabolic disorders.” Fortunately, now that Dr. Uddin and colleagues have a better understanding of the signaling that occurs during preeclampsia, treatments that inhibit specific signals may be investigated in the future.