Ming Zhang1, Philip Wan2, Kenneth Ng3, Kurnvir Singh2, Tzu Hsuan Cheng4, Ivan Velickovic5, Mudar Dalloul6, David Wlody7. 1. Associate Professor, Departments of Anesthesiology; Cell Biology; Obstetrics and Gynecology. 2. Medical Student. 3. Resident. 4. Research Fellow. 5. Director of OB Anesthesia, Department of Anesthesiology. 6. Associate Professor and Director of Labor and Delivery, Department of Obstetrics and Gynecology. 7. Professor and Chair, Department of Anesthesiology, State University of New York-Downstate Medical Center, Brooklyn, NY.
Abstract
IMPORTANCE: Preeclampsia is a devastating disease of pregnancy associated with increased risk of fetal and maternal complications. African American pregnant women have a high prevalence of preeclampsia, but there is a need of systemic analyses of this high-risk group regarding complications, etiology, and biomarkers. OBJECTIVE: The aim of this study was to provide a synopsis of current research of preeclampsia specifically related to African American women. EVIDENCE ACQUISITION: A comprehensive search was performed in the bibliographic database PubMed with keywords "preeclampsia" and "African American." RESULTS: African American women with preeclampsia were at an increased risk of preterm birth, which resulted in low-birth-weight infants. Intrauterine fetal death among African American preeclamptic patients occurs at twice the rate as in other races. On the maternal side, African American mothers with preeclampsia have more severe hypertension, antepartum hemorrhage, and increased mortality. Those who survive preeclampsia have a high risk of postpartum cardiometabolic disease. Preexisting conditions (eg, systemic lupus erythematosus) and genetic mutations (eg, sickle cell disease in the mother, FVL or APOL1 mutations in the fetus) may contribute to the higher prevalence and worse outcomes in African American women. Many blood factors, for example, the ratio of proteins sFlt/PlGF, hormones, and inflammatory factors, have been studied as potential biomarkers for preeclampsia, but their specificity needs further investigation. CONCLUSIONS: Further studies of preeclampsia among African American women addressing underlying risk factors and etiologies, coupled with identification of preeclampsia-specific biomarkers allowing early detection and intervention, will significantly improve the clinical management of this devastating disease.
IMPORTANCE: Preeclampsia is a devastating disease of pregnancy associated with increased risk of fetal and maternal complications. African American pregnant women have a high prevalence of preeclampsia, but there is a need of systemic analyses of this high-risk group regarding complications, etiology, and biomarkers. OBJECTIVE: The aim of this study was to provide a synopsis of current research of preeclampsia specifically related to African American women. EVIDENCE ACQUISITION: A comprehensive search was performed in the bibliographic database PubMed with keywords "preeclampsia" and "African American." RESULTS: African American women with preeclampsia were at an increased risk of preterm birth, which resulted in low-birth-weight infants. Intrauterine fetal death among African American preeclamptic patients occurs at twice the rate as in other races. On the maternal side, African American mothers with preeclampsia have more severe hypertension, antepartum hemorrhage, and increased mortality. Those who survive preeclampsia have a high risk of postpartum cardiometabolic disease. Preexisting conditions (eg, systemic lupus erythematosus) and genetic mutations (eg, sickle cell disease in the mother, FVL or APOL1 mutations in the fetus) may contribute to the higher prevalence and worse outcomes in African American women. Many blood factors, for example, the ratio of proteins sFlt/PlGF, hormones, and inflammatory factors, have been studied as potential biomarkers for preeclampsia, but their specificity needs further investigation. CONCLUSIONS: Further studies of preeclampsia among African American women addressing underlying risk factors and etiologies, coupled with identification of preeclampsia-specific biomarkers allowing early detection and intervention, will significantly improve the clinical management of this devastating disease.
Authors: April M Falconi; Samantha G Bromfield; Trúc Tang; Demetria Malloy; Denae Blanco; Rn Susan Disciglio; Rn Winnie Chi Journal: EClinicalMedicine Date: 2022-07-01
Authors: Megan A Opichka; Matthew W Rappelt; David D Gutterman; Justin L Grobe; Jennifer J McIntosh Journal: Cells Date: 2021-11-06 Impact factor: 7.666