Prepregnancy obesity and complement system activation in early pregnancy and the subsequent development of preeclampsia - 26/04/12
Résumé |
Objective |
We hypothesized that women who are obese before they become pregnant and also have elevations of complement Bb and C3a in the top quartile in early pregnancy would have the highest risk of preeclampsia compared with a referent group of women who were not obese and had levels of complement less than the top quartile.
Study Design |
This was a prospective study of 1013 women recruited at less than 20 weeks' gestation. An EDTA-plasma sample was obtained, and complement fragments were measured using enzyme-linked immunosorbent assays. The data were analyzed using univariable and multivariable logistic regression analysis.
Results |
Women who were obese with levels of Bb or C3a in the top quartile were 10.0 (95% confidence interval, 3.3–30) and 8.8 (95% confidence interval, 3–24) times, respectively, more likely to develop preeclampsia compared with the referent group.
Conclusion |
We demonstrate a combined impact of obesity and elevated complement on the development of preeclampsia.
Le texte complet de cet article est disponible en PDF.Key words : complement system, obesity, preeclampsia
Plan
| This study was supported by American Heart Association Award 0865481G, National Institute of Child Health and Human Development grant K23 HD049684, the Center for Women's Health Research and the List Family Foundation at the University of Colorado–Denver, and Newborn Hope Colorado (A.M.L.); National Institutes of Health grant AR49772 and AR38889 (J.E.S.); and National Institutes of Health grant RO1 AI 55007 (V.M.H.). |
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| A.M.L. and N.A.W. report no potential conflict of interest. R.H.E. has served as a consultant to Merck, Sanofi-Aventis, Pfizer, Esperion, Novo Novartis, Genfit, and GTC Nutrition; he has grants from GSK and Sanofi-Aventis and has been paid for lectures by SCI MED, Vindico, and Vox Media and for manuscript preparation by the Endocrine Society and the American Diabetes Association. R.S.G. has served as a consultant to Novartis Vaccines and Diagnostics. P.C.G. has served as a consultant to Viropharma and has received payment for lectures, travel, and hotel accommodation by DACC. J.E.S. has served as a consultant to Alexion Pharmaceuticals. V.M.H. is a cofounder of Taligen Therapeutics, a complement therapeutics company, and has been a consultant, part-time employee, and Chief Scientific Officer to that company, in which he has owned stock; he is an inventor of patents for complement therapeutics and has received royalties for these patents. The study reported here was performed in his role as Professor of Medicine at the University of Colorado and as a mentor to A.M.L. |
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| James R. Murphy, PhD is deceased. |
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| Reprints not available from the authors. |
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| Cite this article as: Lynch AM, Eckel RH, Murphy JR, et al. Prepregnancy obesity and complement system activation in early pregnancy and the subsequent development of preeclampsia. Am J Obstet Gynecol 2012;206:428.e1-8. |
Vol 206 - N° 5
P. 428.e1-428.e8 - mai 2012 Retour au numéro
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