Early Pregnancy Serum Metabolite Profiles Associated with Hypertensive Disorders of Pregnancy in African American Women: A Pilot Study

• Type of Material: Article
• Authors: Erin Ferranti, Emory University; Jennifer Frediani, Emory University; Rebecca Mitchell, Emory University; Jolyn Fernandes, Emory University; Shuzhao Li, Emory University; Dean Jones, Emory University; Elizabeth Corwin, Emory University; Anne Dunlop, Emory University
• Language: English
• Date: 2020-01-01
• Publisher: Hindawi
• Publication Version: Final Published Version
• Copyright Statement: © 2020 Erin P. Ferranti et al.
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1155/2020/1515321
• Title of Journal or Parent Work: Journal of Pregnancy
• Volume: 2020
• Start Page: 1515321
• End Page: 1515321
• Grant/Funding Information: This manuscript was supported by funding from the National Institutes of Health, National Institutes of Nursing Research (R01NR014800 and K01NR017664), the Office of the Director (UG3/UH3OD023318), the National Institute of Environmental Health Sciences (P50ES926071, P30 ES019776, and R24ES029490), the Office of Research on Women's Health (K12HD085850), and the U.S. Environmental Protection Agency (83615301 Mod. 2).
• Keywords: Humans; Hypertension; Pilot Projects; Adult; Serum; Female; Biomarkers; Young Adult; Male; Pregnancy Complications, Cardiovascular; Pregnancy
• Research Categories: Health Sciences, Medicine and Surgery; Health Sciences, Obstetrics and Gynecology; Health Sciences, Nursing

Abstract

Hypertensive disorders of pregnancy (HDP) are the most common cardiometabolic complications of pregnancy, affecting nearly 10% of US pregnancies and contributing substantially to maternal and infant morbidity and mortality. In the US, women of African American race are at increased risk for HDP. Early biomarkers that reliably identify women at risk for HDP remain elusive, yet are essential for the early identification and targeting of interventions to improve maternal and infant outcomes. We employed high-resolution metabolomics (HRM) to identify metabolites and metabolic pathways that were altered in early (8-14 weeks) gestation serum samples of pregnant African American women who developed HDP after 20 weeks' gestation (n=20) - either preeclampsia (PE; n=11) or gestational hypertension (gHTN; n=9) - compared to those who delivered full term without complications (n=80). We found four metabolic pathways that were significantly (p<0.05) altered in women who developed PE and five pathways that were significantly (p<0.05) altered in women who developed gHTN compared to women who delivered full term without complications. We also found that four specific metabolites (p<0.05) were distinctly upregulated (retinoate, kynurenine) or downregulated (SN-glycero-3-phosphocholine, 2′4′-dihydroxyacetophenone) in women who developed PE compared to gHTN. These findings support that there are systemic metabolic disruptions that are detectable in early pregnancy (8-14 weeks of gestation) among pregnant African American women who develop PE and gHTN. Furthermore, the early pregnancy metabolic disruptions associated with PE and gHTN are distinct, implying they are unique entities rather than conditions along a spectrum of the same disease process despite the common clinical feature of high blood pressure.