Genes, autoimmune response might cause preeclampsia

Raleigh, N.C. —

Researchers at Duke and North Carolina State universities think that previously unknown genes might cause a life-threatening condition for pregnant women and their unborn children.

Preeclampsia occurs in about one of every 10 pregnancies and is responsible for 15 percent of preterm births.

Melanie Moreschi noticed symptoms of preeclampsia late in her first pregnancy.

"Women have high blood pressure they generally develop late in pregnancy. It's a condition where the placenta appears to outgrow its blood supply," said Dr. Andra James, an obstetrician/gynecologist with the Duke Perinatal Fetal Diagnostic.

The condition can led to strokes, seizures and organ failure in the mother, as well as preterm birth.

Moreschi delivered six weeks early, and the now 22-month-old girl is doing fine. Symptoms of preeclampsia returned, though, during Moreschi's second pregnancy.

"We're doing more monitoring this time and also keeping a close eye on me," she said.

Moreschi has rheumatoid arthritis, and while women with similar autoimmune disease have appeared to be at greater risk of preeclampsia, the cause was unclear.

Dr. Jorge Piedrahita, a genomics professor at N.C. State's College of Veterinary Medicine, had been studying the genetic makeup of pig placentas and how they influence the fetus. His work grew into a collaboration with Duke comparing normal human placentas with those from preeclampsic births.

"There's a set of five genes, all of which are involved in autoimmune diseases," Piedrahita said.

Researchers found that an autoimmune response is affecting the roots of the placenta in women with preeclampsia.

"What seems to be happening is the mom is attacking the placental tissue," Piedrahita said.

The finding, published in the journal Placenta, "gives us a new target in our investigations into the mechanisms and cause of preeclampsia," James said.

The knowledge could also help doctors identify and treat at-risk patients earlier.

Moreschi said she benefited from knowing that she was at risk earlier.

"The careful monitoring and frequent doctor visits and ultrasounds and non-stress tests have certainly helped a lot," she said.

Moreschi gave birth to her second daughter after induced labor at 37 weeks. Both mom and baby are doing fine.

The NIH funded research was published in the journal Placenta.

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I myself had this with my second child. I started having the symptoms around week 25. Gave birth the day of week 30, it was no joke! I give my creator above all thanks! I had an excellent team of Dr's @ Rex I to thank them as well. My doctor explained to me that the chances of having this again was very likely but could be worse each time. For those whom are pregnant now keep a watchful eye out on this condition. Because it can go from mild to severe in a blink of an eye! I do not wish these on no one! My little girl did fine, is now 5 and starts school in the fall. :)

showsomelove
March 31, 2011 11:44 a.m.

I worked on this study...happy to see the promise moving forward.

Hammerhead
March 30, 2011 8:47 a.m.

All pregnant women should be aware of the signs and symptoms, and trust their instincts to know when something isn't right. High blood pressure, protein in the urine, headache, vision changes, swelling of the face or swelling in the morning, and abdominal pain should all be reported as early as possible to the Obstetrician. The Raleigh Promise Walk for Preeclampsia is held annually on the Saturday before Mother's Day to raise awareness of this potentially life-threatening disease of pregnancy. Help and support are out there. www.promisewalk.org or www.preeclampsia.org

lgarvie28
March 29, 2011 9:09 a.m.

@Baybee Doll - I delivered my first baby at 32 weeks (I developed HELLP), and like you, was scared to try again. However, I did, and I was monitored very closely, took one baby aspirin every day, along with a daily Omega3 vitamin any my prenatal vits, and I made it to my scheduled c-section date with absolutely no blood pressure issues, or anything I experienced the first time. As long as you're monitored closely, as you will be if you've had it before, don't worry about trying again. Good luck to you!

Toddlermother
March 29, 2011 9:02 a.m.

And here I was, thinking it happened b/c I was fat. In any case, mild as it was, I'm still scared of getting pregnant again.