Predisposition to superimposed preeclampsia in women with chronic hypertension: endothelial, renal, cardiac, and placental factors in a prospective longitudinal cohort

Abstract

Objective To assess the contribution of maternal and placental factors to the development of superimposed preeclampsia in women with chronic hypertension. Methods Endothelial and renal function markers were serially assessed in 90 pregnant women with chronic hypertension and controls. Results Syndecan-1 concentrations were lower at 26–27+6 weeks in women with chronic hypertension who subsequently developed superimposed preeclampsia compared with those who did not. Decreased PlGF and raised urine albumin:creatinine ratio were also associated with development of superimposed preeclampsia. Conclusion Decreased syndecan-1 and PlGF concentrations implicate endothelial glycocalyx disturbance and reduced placental angiogenic capacity, respectively, in the pathophysiology of superimposed preeclampsia.

Keywords

• chronic hypertension
• superimposed preeclampsia
• endothelium
• kidney
• placenta