Systematic review and metaanalysis on nonclassic cardiovascular biomarkers after hypertensive pregnancy disorders

Sanne Visser*, Wietske Hermes, Johannes C.F. Ket, René H.J. Otten, Maria G. Van Pampus, Kitty W.M. Bloemenkamp, Arie Franx, Ben W. Mol, Christianne J.M. De Groot

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

27 Citations (Scopus)

Abstract

Objective The aim of this study was to investigate which nonclassic cardiovascular biomarkers are associated with persistent endothelial dysfunction after pregnancy in women with a history of hypertensive pregnancy disorders compared with women with uncomplicated pregnancies. Study Design This was a systematic review and metaanalysis of observational studies. A search was performed in PubMed, Embase, Cochrane, and Cinahl including articles from inception to Feb. 27, 2013. Included were cohort studies and case-control studies. Cases were women with a history of hypertension in pregnancy, control subjects were women with a history of uncomplicated pregnancies. Of the 3136 found, 21 studies on 16 nonclassic cardiovascular biomarkers are described in this review; 12 studies on 5 biomarkers were included in the metaanalysis.

Results Women with a history of hypertensive pregnancy disorders had a higher homocysteine level compared with women with a history of uncomplicated pregnancies (5 studies; pooled mean difference, 0.77 ng/mL; 95% confidence interval, 0.27-1.26; P <.01). For the other nonclassic cardiovascular biomarkers including markers in areas of inflammation, thrombosis, and angiogenesis, we found no significant differences.

Conclusion This review and metaanalysis showed that women with a history of hypertensive pregnancy disorders have higher homocysteine levels compared with women with a history of uncomplicated pregnancies. These data suggest persistent endothelial alteration after pregnancies complicated by hypertensive disorders.

Original languageEnglish
Pages (from-to)373.e1-373.e9
JournalAmerican Journal of Obstetrics and Gynecology
Volume211
Issue number4
DOIs
Publication statusPublished - 1 Oct 2014

Keywords

  • cardiovascular risk
  • hypertensive pregnancy disorders
  • preeclampsia
  • pregnancy-induced hypertension

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