RESUMEN
Preeclampsia is a serious complication of pregnancy, affecting both maternal and fetal health. In genome-wide association meta-analysis of European and Central Asian mothers, we identify sequence variants that associate with preeclampsia in the maternal genome at ZNF831/20q13 and FTO/16q12. These are previously established variants for blood pressure (BP) and the FTO variant has also been associated with body mass index (BMI). Further analysis of BP variants establishes that variants at MECOM/3q26, FGF5/4q21 and SH2B3/12q24 also associate with preeclampsia through the maternal genome. We further show that a polygenic risk score for hypertension associates with preeclampsia. However, comparison with gestational hypertension indicates that additional factors modify the risk of preeclampsia.
Asunto(s)
Predisposición Genética a la Enfermedad , Hipertensión Inducida en el Embarazo/genética , Herencia Multifactorial , Preeclampsia/genética , Proteínas Adaptadoras Transductoras de Señales/genética , Adulto , Anciano , Dioxigenasa FTO Dependiente de Alfa-Cetoglutarato/genética , Asia Central/epidemiología , Presión Sanguínea/genética , Estudios de Casos y Controles , Conjuntos de Datos como Asunto , Europa (Continente)/epidemiología , Femenino , Factor 5 de Crecimiento de Fibroblastos/genética , Sitios Genéticos/genética , Estudio de Asociación del Genoma Completo , Humanos , Hipertensión Inducida en el Embarazo/epidemiología , Proteína del Locus del Complejo MDS1 y EV11/genética , Persona de Mediana Edad , Preeclampsia/epidemiología , Embarazo , Estudios ProspectivosRESUMEN
OBJECTIVE: The purpose of this study was to determine whether an association exists between intrauterine growth restriction (IUGR) and second-trimester placental location. METHODS: A case-control study was performed in well-dated singleton pregnancies with (n = 67) and without (n = 205) IUGR (defined as estimated fetal weight <10th percentile for gestational age at the last sonographic examination) to investigate the association between IUGR and placental location. Placental location was determined by sonography at 16 to 20 weeks' gestation. Maternal, perinatal, and delivery characteristics were abstracted from medical records. Group comparisons were made by the Student t test, chi(2) analysis, the Fisher exact test, the Wilcoxon test, and analysis of variance. Multivariable logistic regression analysis was used to determine the relationship between IUGR and placental location. RESULTS: In both groups, the most common placental locations in the second trimester were anterior and posterior. After adjusting for potential confounders (including race, chronic hypertension, and hypertensive disorders of pregnancy), IUGR pregnancies were nearly 4-fold more likely to have lateral placentation (odds ratio, 3.8; 95% confidence interval, 1.3-11.2) compared with anterior or posterior placentation. CONCLUSIONS: Pregnancies complicated by IUGR are significantly more likely than non-IUGR pregnancies to have lateral placentation in the second trimester.
Asunto(s)
Retardo del Crecimiento Fetal/clasificación , Retardo del Crecimiento Fetal/diagnóstico por imagen , Placenta/diagnóstico por imagen , Resultado del Embarazo , Medición de Riesgo/métodos , Ultrasonografía Prenatal/métodos , Estudios de Casos y Controles , Femenino , Humanos , Recién Nacido , Embarazo , Reproducibilidad de los Resultados , Factores de Riesgo , Sensibilidad y Especificidad , Estadística como AsuntoRESUMEN
The hypothalamic-pituitary-adrenal axis is central to mammalian reproductive function, including conception, pregnancy maintenance, parturition, and breastfeeding. Pregnancy is associated with substantial physiologic changes within this endocrine axis to meet the demands of pregnancy, which include support of the fetus (volume support, nutritional and oxygen supply, clearance of fetal waste), protection of the fetus (from starvation, drugs, toxins), preparation of the uterus for labor, and protection of the mother from potential cardiovascular injury at delivery. This article reviews the anatomy, embryology, and physiology of the pituitary. The effect of pregnancy on pituitary structure and function, in health and disease, also is discussed.
