Serum Macrophage Colony-Stimulating Factor Relates to the Severity and the Pregnancy Outcomes in Hypertensive Disorders Complicating Pregnancy.

PURPOSE: This study aimed to assess the predictive value of macrophage colony-stimulating factor (M-CSF) in the first trimester for hypertensive disorders complicating pregnancy (HDCP) and its association with disease severity and adverse pregnancy outcomes. HDCP pose significant risks to both maternal health and fetal health. M-CSF is implicated in the pathogenesis of HDCP by promoting inflammation and endothelial damage. METHODS: Serum levels of M-CSF were measured using an enzyme-linked immunosorbent assay, and clinical characteristics and pregnancy outcomes were compared between groups. RESULTS: Pregnant women with HDCP had significantly higher levels of proteinuria, systolic blood pressure, and diastolic blood pressure compared to those with normal pregnancy. Among patients with HDCP, the severity of disease correlated positively with serum levels of M-CSF. Furthermore, M-CSF levels in the first trimester were significantly associated with adverse pregnancy outcomes. The findings suggest that M-CSF may serve as a potential biomarker for predicting HDCP and its severity, as well as adverse pregnancy outcomes. CONCLUSIONS: Early detection and monitoring of M-CSF levels could aid in identifying high-risk pregnancies and implementing appropriate interventions to improve maternal and fetal outcomes.

Role of placental barrier on trace element transfer in maternal fetal system and hypertensive disorders complicating pregnancy and gestational diabetes mellitus.

BACKGROUND: Hypertensive disorders complicating pregnancy (HDCP) and gestational diabetes mellitus (GDM) can affect the placental barrier function to varying degrees. However, current studies show that the transfer and distribution characteristics of trace elements in the maternal-fetal system are still unclear. This study investigated the effect of the placental barrier on the transfer of trace elements from mother to fetus and its relationship with HDCP and GDM. METHODS: A case-control method was used in this study. 140 pairs of samples were collected; 60 were from healthy pregnant women, and 80 were from patients with pregnancy complications. The contents of trace elements in paired samples were determined by inductively coupled plasma-mass spectrometry (ICP-MS). SPSS software was used to analyze the differences in trace element levels in matched samples of each group. The correlations were analyzed based on Pearson's correlation factor (r). RESULTS: The distribution characteristics of Fe content in the pathological group (HDCP group and GDM group) were the same as those in the normal group (umbilical cord blood > maternal blood > placenta), but there was no significant difference in the iron content in maternal blood and cord blood of pathological group. The distribution characteristics of Mn content in the pathological group (placenta > umbilical cord blood > maternal blood) were changed compared with those in the normal group (placenta > maternal blood > umbilical cord blood). In addition, the placental Cr content and cord blood Cr and Ni content of the pathological group were higher than those of the normal group. HDCP placental Cr and GDM placental Fe levels were significantly correlated with the Apgar score. CONCLUSIONS: The transfer of Fe and Mn and the placental barrier function of Cr and Ni in the maternal-fetal system of HDCP and GDM are significantly altered, which directly or indirectly increases the maternal and fetal health risk.

High miR-200a-3p expression has high diagnostic values for hypertensive disorders complicating pregnancy and predicts adverse pregnancy outcomes.

BACKGROUND: Hypertensive disorders complicating pregnancy (HDCP) are various heterogeneous conditions. microRNA (miR)-200a-3p is involved in HDCP diagnosis. This study explored the effects of miR-200a-3p on HDCP patients. METHODS: A total of 126 singleton HDCP patients including 50 cases of gestation hypertension (GH), 42 cases of mild preeclampsia (MP) and 34 cases of severe preeclampsia (SP), were enrolled as study subjects, and 50 normal pregnant women were selected as the control. Serum miR-200a-3p expression was detected and its efficacy in HDCP diagnosis and grading was evaluated. GH, MP and SP patients were allocated to high/low miR-200a-3p expression groups. The correlation between miR-200a-3p expression and general clinical indexes was analyzed. HDCP patients were allocated to high/low miR-200a-3p expression group and maternal and fetal outcomes were followed up. Effects of miR-200a-3p expression on adverse pregnancy outcome incidence were analyzed. RESULTS: miR-200a-3p expression in the serum of HDCP patients was upregulated. The sensitivity and specificity of serum miR-200a-3p level > 1.201 were 87.3% and 96.0%, respectively. Serum miR-200a-3p level in GH, MP and SP patients was increased with the aggravation of the disease. The cut-off value and area under the curve (AUC) of miR-200a-3p for GH, MP and SP diagnosis were 1.145 and 0.9094 (82.0% sensitivity and 88.0% specificity), 1.541 and 0.8126 (73.8% sensitivity and 76.0% specificity), and 1.866 and 0.7367 (64.7% sensitivity and 76.2% specificity), respectively. Serum miR-200a-3p level was correlated with general clinical indexes, fetal birth weight, systolic to diastolic ratio, and fetal growth restriction incidence. High serum miR-200a-3p expression in HDCP patients was associated with increased adverse pregnancy outcomes. CONCLUSION: High miR-200a-3p expression could help to diagnose HDCP, judge severity and was associated with increased adverse pregnancy outcomes.

Prevalence and the influencing factors for critical situation of 6 579 pregnant women with hypertensive disorders complicating pregnancy. / 6 579ä¾‹å¦Šå¨ æœŸé«˜è¡€åŽ‹ç–¾ç— å­•äº§å¦‡çš„æ‚£ç— æƒ å†µåŠå‘ç”Ÿå±é‡æƒ å†µçš„å½±å“å› ç´ .

OBJECTIVES: Hypertensive disorders complicating pregnancy is a kind of disease that seriously endangers the health of pregnant women and fetuses with high incidence. This study aims to analyze the prevalence of pregnant women with hypertensive disorders complicating pregnancy and the influential factors for critical pregnant women, and to provide basis for intervention measures. METHODS: In an institution-based cross-sectional study, 100 683 pregnant women, who gave birth in all maternal and child health hospitals of Hunan Province from January 1, 2012 to December 31, 2019, were collected, and 6 579 pregnant women with hypertensive disorders complicating pregnancy were monitored. All data were analyzed through SAS9.4 software. The basic situation, clinical data, outcome, and complications of pregnant women were analyzed, and the risk factors for critical pregnant women with hypertensive disorders complicating pregnancy were analyzed. RESULTS: The prevalence rate of hypertensive disorder complicating pregnancy was increased from 4.3% in 2012 to 7.1% in 2019, and the proportion of hypertensive disorder complicating pregnant women with complications in the hypertensive disorder complicating pregnant women was increased from 28.1% in 2012 to 83.7% in 2019. Elderly pregnant women accounted for 22.2%, married women accounted for 99.9%, women with university degree accounted for 49.5%, one pregnancy accounted for 38%, and zero delivery accounted for 63.5%. In the past, 18.4% of pregnant women had more than one cesarean section, accounting for 18.4%. About 99.0% of pregnant women had 5-10 antenatal check-ups, 72.6% had complications, and 93.8% were terminated when they were discharged. The first 3 complications were anemia in 2 355 cases (29.3%), gestational diabetes in 1 886 cases (23.4%), and subclinical hypothyroidism in 947 cases (11.8%). Logistic regression analysis showed that uterine rupture, placental abruption, placenta previa, anemia, and heart disease were independent risk factors for critical pregnant women. CONCLUSIONS: The prevalence of hypertensive disorders complicating pregnancy is on the rise. Pregnancy examination should be enhanced to identify the complications such as hypothyroidism, gestational diabetes, and anemia. Prevention and treatment measures should be actively taken for uterine rupture, placental abruption, placenta previa, anemia, and heart disease.

Negative association between serum adropin and hypertensive disorders complicating pregnancy.

Objective: Study the association of adropin and hypertensive disorders complicating pregnancy (HDCP). Methods: Patients with HDCP were matched with normotensive women (47 pairs). Adropin concentrations were detected by enzyme-linked immunosorbent assay. Results: Compared with the controls, the serum adropin levels were lower in the HDCP group (P < 0.001) and in HDCP subgroups (gestational hypertension, mild preeclampisa, and severe preeclampsia, term, preterm, early onset, and late onset) (all P < 0.05). After adjustment for confounders, adropin remained negatively associated with HDCP (P = 0.027). Conclusion: Lower adropin concentration is significantly associated with HDCP, suggesting that higher or normal adropin levels may be protective against HDCP.

Levels of microRNA-181b and plasminogen activator inhibitor-1 are associated with hypertensive disorders complicating pregnancy.

The aim of the present study was to explore the association between the expression of microRNA (miRNA)-181b and plasminogen activator inhibitor-1 (PAI-1) in the placental tissue of pregnant females with a hypertensive disorder complicating pregnancy (HDCP). Placental tissue samples were obtained from 48 patients with HDCP and 40 females with a normal pregnancy. The levels of miRNA-181b and PAI-1 mRNA were determined by the reverse transcription-quantitative polymerase chain reaction (RT-qPCR). The expression of PAI-1 protein was analyzed by western blotting. Vascular smooth muscle cells (VSMCs) were transfected with the pEGP-miRNA-181b plasmid using Lipofectamine® 2000. Transfection efficiency was confirmed by immunohistochemical analysis. The levels of miRNA-181b in the placental tissue of patients with HDCP were lower than those in the control group, whereas the levels of PAI-1 mRNA in the placental tissue of patients with HDCP were higher than those in the control group. The expression of the PAI-1 protein in the HDCP group was higher than that in the control group. Following transfection of VSMCs with plasmid pGCMV/EGFP/miRNA-181b, the levels of PAI-1 mRNA were reduced while the levels of miRNA-181 were upregulated. Furthermore, the expression levels of PAI-1 protein were lower than those in the control group. The levels of miRNA-181b and PAI-1 mRNA were strongly associated with HDCP. Thus, miRNA-181b may play an important role in the regulation of PAI-1. PAI-1 and miRNA-181b may be novel biomarkers to be used in HDCP therapy.