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ISSN 1527-3172 (Electronic)

2013, Number 3

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MEDICC Review 2013; 15 (3)

Contribution of genome–environment interaction to pre-eclampsia in a Havana Maternity Hospital

Lardoeyt R, Vargas G, Lumpuy J, García R, Torres Y

Language: Spanish
References: 51
Page: 22-29
PDF size: 263.35 Kb.


ABSTRACT

Introduction: Pre-eclampsia is a major cause of morbidity and mortality during pregnancy worldwide and is among the leading causes of maternal mortality in Cuba. It is a complex, multifactoral disease, in which interaction of genetic and environmental factors should not be overlooked if the goal is proper risk assessment to support personalized preventive genetic counseling and more effective prenatal care to prevent pregnancy complications.
Objetive: Determine the contribution to pre-eclampsia of interaction between a predisposing genome and adverse environmental factors in pregnant women in a Havana maternity hospital.
Methods: This was the exploratory phase of a hospital-based case-control study, using January 2007–December 2009 patient records from the Eusebio Hernández University Hospital, a provincial maternity hospital in Havana. Eighty pregnant women diagnosed with pre-eclampsia and 160 controls were studied. The main variables were age, parity, nutritional status (measured by BMI), alcohol use, tobacco use, and history of pre-eclampsia in relatives of the pregnant woman (proband) or of her partner. Pearson chi square and Fisher exact test were used to assess statistical significance of associations between variables and odds ratio as a measure of association strength. Familial aggregation was studied and a case-control design used to assess gene–environment interaction, using multiplicative and additive models.
Results: Among the environmental risk factors studied, alcohol showed the strongest effect on pre-eclampsia risk (OR 3.87, 95% CI 1.64–9.13). Familial pre-eclampsia clustering was observed; risk was increased for both first-degree (OR 2.43, 95% CI 1.62–3.73) and second-degree (OR 1.89, 95% CI 1.34–2.68) relatives as well as for husband's relatives (OR 2.32, 95% CI 1.40–3.86). There was evidence of interaction between alcohol consumption and family history.
Conclusions: Familial aggregation of the disorder was demonstrated, the first Cuban epidemiological evidence of genetic and enviromental contributions to pre-eclampsia risk. Familial clustering among the husband's relatives demonstrates the fetal genome's importance in genesis of pre-eclampsia. The interaction of environmental risk factors with genetic ones produces increased pre-eclampsia risk, compared to expectations based on independent action of these variables.


REFERENCES

  1. Carty DM, Delles C, Dominiczak AF. Preeclampsia and future maternal health. J Hypertens. 2010 Jul;28(7):1349–55.

  2. Moster D, Lie RT, Markestad T. Long-term medical and social consequences of preterm birth. N Engl J Med. 2008 Jul 17;359(3): 262–73.

  3. Duley L. The global impact of pre-eclampsia and eclampsia. Semin Perinatol. 2009 Jun;33(3):130–7.

  4. Uzan J, Carbonnel M, Piconne O, Asmar R, Ayoubi JM. Pre-eclampsia: pathophysiology, diagnosis, and management. Vasc Health Risk Manag. 2011;7:467–74.

  5. Osungbade KO, Ige OK. Public health perspectives of preeclampsia in developing countries: implication for health system strengthening. J Pregnancy. 2011; 2011: doi:10.1155/2011/481095.

  6. Anuario Estadístico de Salud 2012. Havana: Ministry of Public Health (CU); 2013. p. 80.

  7. Gómez E. Trastornos hipertensivos durante el embarazo. Rev Cubana Obstet Ginecol. 2005;26(2):99–114.

  8. Johnson MP, Brennecke SP, East CE, Göring HH, Kent JW Jr, Dyer TD, et al. Genome-wide association scan identifies a risk locus for preeclampsia on 2q14, near the inhibin, beta B gene. PLoS One. 2012;7(3):e33666.

  9. Zhao L, Triche EW, Walsh KM, Bracken MB, Saftlas AF, Hoh J, et al. Genome-wide association study identifies a maternal copy-number deletion in PSG11 enriched among preeclampsia patients. BMC Pregnancy Childbirth. 2012 Jun 29;12:61.

  10. Mütze S, Rudnik-Schöneborn S, Zerres K, Rath W. Genes and the preeclampsia syndrome. J Perinat Med. 2008;36(1):38–58.

  11. Turner JA. Diagnosis and management of preeclampsia: an update. Int J Womens Health. 2010 Sep 30;2:327–37.

  12. Manual de diagnóstico y tratamiento en obstetricia y perinatología. Havana: Editorial Ciencias Médicas; 2000. p. 237–52.

  13. Diago D, Vila F, Ramos E, Garcia R. Factores de riesgo en la hipertensión inducida por el embarazo. Rev Cubana Obstet Ginecol. 2011 Oct– Dec;37(4).

  14. Altunaga M, Lugones M. Incidencia de algunos factores de riesgo en la preeclampsia con signos de gravedad. Rev Cubana Obstet Ginecol. 2010 Jul–Sep;36(3).

  15. Suárez JA, Gutiérrez M, Cabrera MR, Corrales A, Salazar ME. Predictores de la preeclampsia/ eclampsia en un grupo de gestantes de alto riesgo. Rev Cubana Obstet Ginecol. 2011 May– Aug;37(2).

  16. Matthews AG, Finkelstein DM, Betensky RA. Analysis of familial aggregation studies with complex ascertainment schemes. Stat Med. 2008 Oct 30;27(24):5076–92.

  17. Griffiths JFA, Miller HJ, Susuki DT, Lew WM. Genética. 5th ed. Madrid: McGraw-Hill/Interamericana de España S.A; 1993. p.1–863.

  18. Morgan-Ortiz F, Calderón-Lara SA, Martínez- Félix JI, González-Beltrán A, Quevedo-Castro E. [Risk factors associated with preeclampsia: case-control study]. Ginecol Obstet Mex. 2010 Mar;78(3):153–9.

  19. Fang R, Dawson A, Lohsoonthorn V, Williams MA. Risk Factors of Early and Late Onset Preeclampsia among Thai Women. Asian Biomed (Res Rev News). 2009 Oct 1;3(5):477–86.

  20. Roberts CL, Ford JB, Algert CS, Antonsen S, Chalmers J, Cnattingius S, et al. Populationbased trends in pregnancy hypertension and pre-eclampsia: an international comparative study. BMJ Open. 2011 May 24;1(1):e000101.

  21. Chappell LC, Seed P, Enye S, Briley AL, Poston L, Shennan AH. Clinical and geographical variation in prophylactic and therapeutic treatments for pre-eclampsia in the UK. BJOG. 2010 May;117(6):695–700.

  22. Kashanian M, Baradaran HR, Bahasadri S, Alimohammadi R. Risk factors for pre-eclampsia: a study in Iran. Arch Iran Med. 2011 Nov;14(6):412–5.

  23. Pedraza D, Silva A. Síndrome hipertensivo del embarazo. In: Salinas H, Parra M, Valdés E, Carmona S, Opazo D, editors. Obstetricia. 1st ed. Santiago de Chile: Editorial RED; 2005. p. 329–36.

  24. Suárez JA, Gutiérrez M, Cairo V, Bravo Y, Corrales A, Tempo AC. Comportamiento materno y perinatal de un grupo de gestantes con preeclampsia grave. Rev Cubana Obstet Ginecol. 2009 Jul–Sep;35(3).

  25. García FJ, Costales CA, Jimeno JM. Fisiopatología y factores etiopatogénicos de la hipertensión arterial en el embarazo. Revisión de la literatura. Toko-Gin Pract. 2000;59(4):194–212.

  26. Xia Y, Kellems RE. Is preeclampsia an autoimmune disease? Clin Immunol. 2009 Oct;133(1):1–12.

  27. Herse F, Staff AC, Hering L, Müller DN, Luft FC, Dechend R. AT1-receptor autoantibodies and uteroplacental RAS in pregnancy and pre-eclampsia. J Mol Med (Berl). 2008;86(6):697–703.

  28. George EM, Granger JP. Recent insights into the pathophysiology of preeclampsia. Expert Rev Obstet Gynecol. 2010 Sep 1;5(5):557–66.

  29. Reslan OM, Khalil RA. Molecular and vascular targets in the pathogenesis and management of the hypertension associated with preeclampsia. Cardiovasc Hematol Agents Med Chem. 2010 Oct 1;8(4):204–26.

  30. Xiong X, Fraser WD, Demianczuk NN. History of abortion, preterm, term birth, and risk of preeclampsia: A population-based study. Am J Obstet Gynecol. 2002 Oct;187(4):1013–8.

  31. Trogstad L, Magnus P, Skjærven R, Stoltenberg C. Previous abortions and risk of pre-eclampsia. Int J Epidemiol. 2008 Dec;37(6):1333–40.

  32. Ioka A, Tsukuma H, Nakamuro K. Lifestyles and pre-eclampsia with special attention to cigarette smoking. J Epidemiol. 2003 Mar;13(2):90–5.

  33. Llurba E, Sánchez O, Domínguez C, Soro G, Goya M, Alijotas-Reig J, et al. Smoking during pregnancy: changes in mid-gestation angiogenic factors in women at risk of developing preeclampsia according to uterine artery Doppler findings. Hypertens Pregnancy. 2013;32(1):50–9.

  34. Chesley LC, Annitto JE, Cosgrove RA. The familial factor in toxemia of pregnancy. Obstet Gynecol. 1968 Sep;32(3):303–11.

  35. Benedetto C, Marozio L, Ciccone G, Chieppa G, Quaglia M, Matullo G, et al. Synergistic effect of renin-angiotensin system and nitric oxide synthase genes polymorphisms in pre-eclampsia. Acta Obstet Gynecol Scand. 2007;86(6):678–82.

  36. Turner JA. Diagnosis and management of preeclampsia: an update. Int J Womens Health. 2010 Sep;2:327–37.

  37. Valderrama-Aguirre A, Gallo D, Cifuentes R. ¿Cuáles son los avances de la genómica y la proteómica en el tamizaje y/o predicción de la preeclampsia? Rev Colomb Obstet Ginecol. 2011 Feb–Mar;62(1):64–70.

  38. Nilsson E, Salonen Ros H, Cnattingius S, Lichtenstein P. The importance of genetic and environmental effects for pre-eclampsia and gestational hypertension: a family study. BJOG. 2004 Mar;111(3):200–6.

  39. Bezerra PC, Leão MD, Queiroz JW, Melo EM, Pereira FV, Nóbrega MH, et al. Family history of hypertension as an important risk factor for the development of severe preeclampsia. Acta Obstet Gynecol Scand. 2010 May;89(5):612–7.

  40. Cruz J, Hernández P, Yanes M, Isla A. Factores de riesgo de preeclampsia: enfoque inmunoendocrino. Parte I. Rev Cubana Med Gen Integr. 2007;23(4).

  41. Berends AL, Steegers EA, Isaacs A, Aulchenko YS, Liu F, de Groot CJ, et al. Familial aggregation of preeclampsia and intrauterine growth restriction in a genetically isolated population in The Netherlands. Eur J Hum Genet. 2008 Dec;16(12):1437–42.

  42. Mütze S, Rudnik–Schöneborn S, Zerres K, Rath W. Genes and the preeclampsia syndrome. J Perinat Med. 2008;36(1):38–58.

  43. Sayed-Tabatabaei FA, Oostra BA, Isaacs A, van Duijn CM, Witteman JC. ACE polymorphisms. Circ Res. 2006 May 12;98(9):1123–33.

  44. Valencia EY, Canto T, López LB, Coral RM, Canto P. Avances de la genética de la preeclampsia. Rev Especialidades Médico-Quirúrgicas. 2011;16(3):163–8.

  45. Skjaerven R, Vatten LJ, Wilcox AJ, Rønning T, Irgens LM, Lie RT. Recurrence of pre-eclampsia across generations: exploring fetal and maternal genetic components in a population based cohort. BMJ. 2005 Oct 15;331(7521):877.

  46. Tan H, Wen SW, Walker M, Demissie K. Parental race, birth weight, gestational age, and fetal growth among twin infants in the United States. Early Human Dev. 2004;80(2):153–60.

  47. Lie RT, Wilcox AJ, Skjaerven R. Maternal and paternal influences on length of pregnancy. Obstet Gynecol. 2006 Apr;107(4):880–5.

  48. Wilcox AJ, Skaerven R, Lie RT. Familial patterns of preterm delivery: maternal and fetal contributions. Am J Epidemiol. 2008 Feb 15;167(4):474–9.

  49. Palomar L, DeFranco EA, Lee KA, Allsworth JE, Muglia LJ. Paternal race is a risk factor for preterm birth. Am J Obstetrics & Gynecol. 2007 Aug;197(2):152 e1–7.

  50. Maccani MA, Marsit CJ. Epigenetics in the placenta. Am J Reprod Immunol. 2009 Aug;62(2):78–89.

  51. Marcheco B. El programa nacional de diagnóstico, manejo y prevención de enfermedades genéticas y defectos congénitos de Cuba. Período 1981–2009. Rev Genét Comunit. 2009;39(2–3).




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