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Karpova NS, Dmitrenko OP, Budykina TS. Literature Review: The sFlt1/PlGF Ratio and Pregestational Maternal Comorbidities: New Risk Factors to Predict Pre-Eclampsia. Int J Mol Sci 2023; 24:ijms24076744. [PMID: 37047717 PMCID: PMC10095124 DOI: 10.3390/ijms24076744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 03/13/2023] [Accepted: 03/24/2023] [Indexed: 04/08/2023] Open
Abstract
One of the main causes of maternal and neonatal morbidity and mortality is pre-eclampsia. It is characterized by a high sFlt1/PlGF ratio, according to prior research. Pregestational diseases in mothers may increase the risk of developing pre-eclampsia. Only a few studies have looked at the connection between maternal comorbidities before conception and the sFlt1/PlGF ratio. The most recent information regarding the association between maternal pregestational diseases and the ratio of sFlt1/PlGF is described in this review. The paper also examines current research suggesting that changes in pregnancy hormones and metabolites are related to a high sFlt1/PlGF ratio. Certain maternal disorders have been found to dramatically raise sFlt-1 and sFlt1/PlGF levels, according to an analysis of the literature. There is still debate about the data on the association between the sFlt1/PlGF ratio and maternal disorders such as HIV, acute coronary syndromes, cardiovascular function in the mother between 19 and 23 weeks of pregnancy, thyroid hormones, diabetes, and cancer. Additional research is needed to confirm these findings.
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Affiliation(s)
- Nataliia Sergeevna Karpova
- Federal State Budgetary Institution “Research Institute of Pathology and Pathophysiology”, St. Baltiyskaya, House 8, Moscow 125315, Russia
| | - Olga Pavlovna Dmitrenko
- Federal State Budgetary Institution “Research Institute of Pathology and Pathophysiology”, St. Baltiyskaya, House 8, Moscow 125315, Russia
| | - Tatyana Sergeevna Budykina
- State Budgetary Health Institution of the Moscow Region “Moscow Regional Research Institute of Obstetrics and Gynecology”, St. Pokrovka, d.22a, Moscow 101000, Russia
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Serrand C, Mura T, Fabbro-Peray P, Seni G, Mousty È, Boudemaghe T, Gris JC. Assessment of All-Cause Cancer Incidence Among Individuals With Preeclampsia or Eclampsia During First Pregnancy. JAMA Netw Open 2021; 4:e2114486. [PMID: 34160606 PMCID: PMC8223101 DOI: 10.1001/jamanetworkopen.2021.14486] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
IMPORTANCE Preeclampsia or eclampsia (preeclampsia/eclampsia) during pregnancy induces major physiological changes and may be associated with specific cancer occurrences in later life. The current data regarding the association between preeclampsia/eclampsia and cancer are heterogeneous, and cancer risk after preeclampsia/eclampsia could be different depending on the organ. These uncertainties warrant reexamination of the association between preeclampsia/eclampsia and the risk of cancer overall and by specific cancer type. OBJECTIVE To evaluate the risk of cancer, overall and by type, after preeclampsia/eclampsia during a first pregnancy. DESIGN, SETTING, AND PARTICIPANTS This retrospective cohort study used data from the French hospital discharge database to identify all female individuals who had a pregnancy-associated hospitalization between January 1, 2010, and December 31, 2019. To allow a minimum of 2 years for the detection of medical history, individuals with a first detected pregnancy before January 1, 2012, were excluded, as were those with a cancer-associated hospitalization before or during their first detected pregnancy. Exposures, comorbidities, and occurrences of cancer were evaluated using data from the medico-administrative registers of hospitalizations in private and public French hospitals. Cox proportional hazards models were used to analyze cancer risk according to the occurrence of preeclampsia/eclampsia during first pregnancy. EXPOSURES Preeclampsia/eclampsia-associated hospitalization during the first detected pregnancy. MAIN OUTCOMES AND MEASURES The primary outcome was the incidence of cancer, including myelodysplastic or myeloproliferative diseases, after a first pregnancy with and without preeclampsia/eclampsia. RESULTS After exclusions, a total of 4 322 970 female individuals (mean [SD] age at first detected pregnancy, 29.6 [6.2] years) with and without preeclampsia/eclampsia during their first pregnancy were included. Of those, 45 523 individuals (1.1%) were diagnosed with preeclampsia/eclampsia during their first detected pregnancy. The maximum follow-up was 8 years, during which 29 173 individuals (0.7%) were diagnosed with cancer. No significant difference in overall cancer incidence was found between those with and without preeclampsia/eclampsia during their first pregnancy (adjusted hazard ratio [AHR], 0.94; 95% CI, 0.84-1.05). Preeclampsia/eclampsia was associated with an increase in the risk of myelodysplastic syndromes or myeloproliferative diseases (AHR, 2.43; 95% CI, 1.46-4.06) and kidney cancer (AHR, 2.19; 95% CI, 1.09-4.42) and a decrease in the risk of breast cancer (AHR, 0.79; 95% CI, 0.62-0.99) and cervical cancer (AHR, 0.75; 95% CI, 0.58-0.96). CONCLUSIONS AND RELEVANCE In this study, a history of preeclampsia/eclampsia during first pregnancy was associated with an increase in the incidence of myelodysplastic or myeloproliferative diseases and kidney cancer and a decrease in the incidence of cervical and breast cancers. These associations might reflect an underlying common factor among preeclampsia/eclampsia and these pathologies and/or an association between preeclampsia/eclampsia and the development of these cancers.
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Affiliation(s)
- Chris Serrand
- Department of Biostatistics, Clinical Epidemiology, Public Health, and Innovation in Methodology, Centre Hospitalier Universitaire de Nîmes, Groupe Hospitalo–Universitaire Caremeau, Nîmes, France
- Faculty of Medicine, University of Montpellier, Montpellier, France
| | - Thibault Mura
- Department of Biostatistics, Clinical Epidemiology, Public Health, and Innovation in Methodology, Centre Hospitalier Universitaire de Nîmes, Groupe Hospitalo–Universitaire Caremeau, Nîmes, France
- Faculty of Medicine, University of Montpellier, Montpellier, France
| | - Pascale Fabbro-Peray
- Department of Biostatistics, Clinical Epidemiology, Public Health, and Innovation in Methodology, Centre Hospitalier Universitaire de Nîmes, Groupe Hospitalo–Universitaire Caremeau, Nîmes, France
- Faculty of Medicine, University of Montpellier, Montpellier, France
- Institut National de la Santé et de la Recherche Médicale UA11, Institut Desbrest d’Épidémiologie et de Santé Publique, University of Montpellier, Montpellier, France
| | - Gilles Seni
- Department of Medical Information, Methods and Research, Centre Hospitalier Universitaire de Nîmes, University of Montpellier, Nîmes, France
| | - Ève Mousty
- Department of Gynecology and Obstetrics, Centre Hospitalier Universitaire de Nîmes, University of Montpellier, Nîmes, France
| | - Thierry Boudemaghe
- Institut National de la Santé et de la Recherche Médicale UA11, Institut Desbrest d’Épidémiologie et de Santé Publique, University of Montpellier, Montpellier, France
- Department of Medical Information, Methods and Research, Centre Hospitalier Universitaire de Nîmes, University of Montpellier, Nîmes, France
| | - Jean-Christophe Gris
- Institut National de la Santé et de la Recherche Médicale UA11, Institut Desbrest d’Épidémiologie et de Santé Publique, University of Montpellier, Montpellier, France
- Department of Gynecology and Obstetrics, Centre Hospitalier Universitaire de Nîmes, University of Montpellier, Nîmes, France
- Department of Hematology, Centre Hospitalier Universitaire de Nîmes, University of Montpellier, Nîmes, France
- Faculty of Pharmaceutical and Biological Sciences, University of Montpellier, Montpellier, France
- I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation
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Ganmaa D, Enkhmaa D, Baatar T, Uyanga B, Gantsetseg G, Helde TT, McElrath TF, Cantonwine DE, Bradwin G, Falk RT, Hoover RN, Troisi R. Maternal Pregnancy Hormone Concentrations in Countries with Very Low and High Breast Cancer Risk. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E823. [PMID: 32012981 PMCID: PMC7037832 DOI: 10.3390/ijerph17030823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Revised: 01/07/2020] [Accepted: 01/20/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND Breast cancer rates in Asia are much lower than in Europe and North America. Within Asia, rates are lower in Mongolia than in neighboring countries. Variation in pregnancy exposure to endogenous hormone concentrations may explain the differences, but data are lacking. METHODS We measured maternal serum progesterone, prolactin, estradiol and estrone concentrations in the second half of pregnancy in a cross-sectional study of urban (n = 143-194 depending on the analyte) and rural (n = 150-193) Mongolian women, and U.S. women from Boston (n = 66-204). Medical records provided information on maternal and perinatal factors. Geometric mean hormones were estimated from standard linear models with the log-hormone as the dependent variable and country as the independent variable adjusted for maternal and gestational age at blood draw. RESULTS Mean concentrations of prolactin (5722 vs. 4648 uIU/mL; p < 0.0001) and estradiol (17.7 vs. 13.6 ng/mL; p < 0.0001) were greater in Mongolian than U.S. women, while progesterone (147 vs. 201 ng/mL; p < 0.0001) was lower. Mean hormone concentrations were similar in rural and urban Mongolian women. Results were generally similar, with additional adjustment for gravidity, parity, height, body mass index at blood draw, education and alcohol use during pregnancy, and when stratified by offspring sex or parity. CONCLUSIONS Mongolian women had greater concentrations of prolactin and estrogen and lower concentrations of progesterone than U.S. women, while hormone concentrations were similar in rural and urban Mongolian pregnancies. IMPACT These data do not support the hypothesis that estrogen concentrations in pregnant women are lower in Mongolian compared with Caucasian women.
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Affiliation(s)
- Davaasambuu Ganmaa
- Channing Division Network of Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School and Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA;
- Mongolian Health Initiative, Ulaanbaatar 13312, Mongolia; (B.U.); (G.G.)
| | - Davaasambuu Enkhmaa
- Maternal and Child Health Research Center, Ulaanbaatar 16060, Mongolia; (D.E.); (T.B.)
| | - Tsedmaa Baatar
- Maternal and Child Health Research Center, Ulaanbaatar 16060, Mongolia; (D.E.); (T.B.)
| | - Buyanjargal Uyanga
- Mongolian Health Initiative, Ulaanbaatar 13312, Mongolia; (B.U.); (G.G.)
| | - Garmaa Gantsetseg
- Mongolian Health Initiative, Ulaanbaatar 13312, Mongolia; (B.U.); (G.G.)
| | - Thomas T. Helde
- Information Management Services, Inc., Rockville, MD 20850, USA;
| | - Thomas F. McElrath
- Harvard Medical School, Department of Obstetrics and Gynecology, Brigham and Women’s Hospital, Boston, MA 02115, USA; (T.F.M.); (D.E.C.)
| | - David E. Cantonwine
- Harvard Medical School, Department of Obstetrics and Gynecology, Brigham and Women’s Hospital, Boston, MA 02115, USA; (T.F.M.); (D.E.C.)
| | - Gary Bradwin
- Clinical and Epidemiologic Research Laboratory, Boston Children’s Hospital, Boston, MA 02115, USA;
| | - Roni T. Falk
- Epidemiology and Biostatistics Program, Division of Epidemiology and Genetics, National Cancer Institute, Rockville, MD 20850, USA; (R.T.F.); (R.N.H.)
| | - Robert N. Hoover
- Epidemiology and Biostatistics Program, Division of Epidemiology and Genetics, National Cancer Institute, Rockville, MD 20850, USA; (R.T.F.); (R.N.H.)
| | - Rebecca Troisi
- Epidemiology and Biostatistics Program, Division of Epidemiology and Genetics, National Cancer Institute, Rockville, MD 20850, USA; (R.T.F.); (R.N.H.)
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