C A H Rijvers1, S Marzano2, B Winkens3, J A Bakker4, A A Kroon5, M E A Spaanderman6, L L H Peeters7. 1. Department of Obstetrics and Gynecology, Maastricht University Medical Centre, P.O. Box 5800, 6202 AZ Maastricht, The Netherlands. Electronic address: carmen.rijvers@maastrichtuniversity.nl. 2. Department of Obstetrics and Gynecology, Universita La Sapienza, 00185 Rome, Italy. Electronic address: sara1081@inwind.it. 3. Department of Methodology and Statistics, Maastricht University Medical Centre, P.O. Box 5800, 6202 AZ Maastricht, The Netherlands. Electronic address: bjorn.winkens@maastrichtuniversity.nl. 4. Department of Clinical Genetics, Maastricht University Medical Centre, P.O. Box 5800, 6202 AZ Maastricht, The Netherlands. Electronic address: jaap.bakker@mumc.nl. 5. Department of Internal Medicine, Maastricht University Medical Centre, P.O. Box 5800, 6202 AZ Maastricht, The Netherlands. Electronic address: aa.kroon@mumc.nl. 6. Department of Obstetrics and Gynecology, Maastricht University Medical Centre, P.O. Box 5800, 6202 AZ Maastricht, The Netherlands. Electronic address: marc.spaanderman@mumc.nl. 7. Department of Obstetrics and Gynecology, Maastricht University Medical Centre, P.O. Box 5800, 6202 AZ Maastricht, The Netherlands. Electronic address: l.l.h.peeters@umcutrecht.nl.
Abstract
OBJECTIVE: To evaluate early-pregnancy levels of ADMA (asymmetric dimethylarginine) in recurrent hypertensive pregnancy. STUDY DESIGN: In this retrospective observational study, blood samples from 35 normotensive women with a previous hypertensive pregnancy were obtained preconceptionally and at 12, 16 and 20weeks in their next pregnancy. We assessed ADMA, symmetric dimethylarginine (SDMA), l-arginine and l-citrulline. We analyzed differences in longitudinal patterns between normotensive (NT, n=18) and recurrent hypertensive (HT, n=17) pregnancies by linear mixed models, with a sub-analysis for preeclampsia (PE, n=6). MAIN OUTCOME MEASURES: ADMA, SDMA, l-arginine and l-citrulline. RESULTS: Pre-pregnant SDMA and l-citrulline were lower in HT. At 12weeks, ADMA and ADMA/SDMA ratio correlated inversely with PAPP-A and β-hCG, respectively. In both groups, ADMA-related compounds changed inconsistently with advancing (mid-trimester) pregnancy, although in HT, l-arginine tended to decrease between 16 and 20weeks, a decline consistent in PE. CONCLUSION: These data support a modest role for ADMA and related metabolites in the pathogenesis of hypertensive pregnancy.
OBJECTIVE: To evaluate early-pregnancy levels of ADMA (asymmetric dimethylarginine) in recurrent hypertensive pregnancy. STUDY DESIGN: In this retrospective observational study, blood samples from 35 normotensive women with a previous hypertensive pregnancy were obtained preconceptionally and at 12, 16 and 20weeks in their next pregnancy. We assessed ADMA, symmetric dimethylarginine (SDMA), l-arginine and l-citrulline. We analyzed differences in longitudinal patterns between normotensive (NT, n=18) and recurrent hypertensive (HT, n=17) pregnancies by linear mixed models, with a sub-analysis for preeclampsia (PE, n=6). MAIN OUTCOME MEASURES: ADMA, SDMA, l-arginine and l-citrulline. RESULTS: Pre-pregnant SDMA and l-citrulline were lower in HT. At 12weeks, ADMA and ADMA/SDMA ratio correlated inversely with PAPP-A and β-hCG, respectively. In both groups, ADMA-related compounds changed inconsistently with advancing (mid-trimester) pregnancy, although in HT, l-arginine tended to decrease between 16 and 20weeks, a decline consistent in PE. CONCLUSION: These data support a modest role for ADMA and related metabolites in the pathogenesis of hypertensive pregnancy.
Authors: Jussara Mayrink; Debora F Leite; Guilherme M Nobrega; Maria Laura Costa; Jose Guilherme Cecatti Journal: BMJ Open Date: 2022-04-25 Impact factor: 3.006