Cholesterol homeostasis is dysregulated in women with preeclampsia.

INTRODUCTION: The link between preeclampsia and dyslipidemia has been established. Even though lipid profile parameters have been intensively investigated in the pathology of preeclampsia, their accurate molecular mechanisms of action have not been fully decoded. OBJECTIVES: We aimed to identify the specifics of cholesterol metabolism in women affected by late-onset preeclampsia and single out potential biomarkers associated with late-onset syndrome. PATIENTS AND METHODS: A total of 90 pregnant women with a priori risk for preeclampsia were monitored at 4 time points during gestation and, based on the outcome of pregnancy, they were classified into the high-risk group (70 women) and the preeclampsia group (20 women). Cholesterol metabolic profiling was done using liquid chromatography-tandem mass spectrometry. RESULTS: The only significant change in the preeclampsia group was an increase in the lathosterol level (P = 0.001). The first-trimester lathosterol level was higher in the preeclampsia group compared with the high-risk group (P = 0.02). Further, in the preeclampsia group, positive correlations were found between desmosterol and ß-sitosterol (ρ = 0.474; P = 0.03) in the third trimester, desmosterol and campesterol changes between the second and the first (ρ = 0.546; P = 0.02), and the third and first trimesters (ρ = 0.754; P <⁠0.001), as well as between the desmosterol and ß-sitosterol differences between the third and first trimesters (ρ = 0.568; P = 0.01). No similar correlations were found in the high-risk group. CONCLUSIONS: Late-onset preeclampsia could be associated with an altered lipid profile. By studying the quantitative metabolic signatures of cholesterol, we might assume that both cholesterol synthesis and absorption are increased, that is, there is an imbalance in the cholesterol homeostasis regulation in women affected by the disease.

Degree and rate of growth discordance in dichorionic twins conceived by in vitro fertilization.

Objective. Our objective was to estimate degree and rate of discordant growth and its impact on perinatal outcome in dichorionic twin pregnancies conceived by in vitro fertilization (IVF) compared to those conceived spontaneously. Study Design. Growth discordance was defined as 90th percentiles for the study population. Adverse perinatal outcome was defined as 5-minute Apgar score <7 and/or admission to neonatal intensive care unit. Results. In the total study population of dichorionic twins (176 conceived by IVF and 215 spontaneously), 30% discordant growth represented the 90th percentile. After adjusting for gestational age, discordant twins conceived by IVF or spontaneously were at higher risk for adverse perinatal outcome (hazard ratio 4.4; 95% CI 2.4-8.3, P < 0.0001; hazard ratio 2.5; 95% CI 1.5-4.4, P = 0.001, resp.). Similar rates of 5-minute Apgar score <7, admission to neonatal intensive care unit, and delivery <34 weeks were found between discordant twins conceived by IVF and those conceived spontaneously. Conclusion. Dichorionic twins conceived by IVF are at similar risk for the rate and degree of discordant growth and adverse perinatal outcome compared to dichorionic twins conceived spontaneously.