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(Hypertension. 2004;44:708.)
© 2004 American Heart Association, Inc.

Scientific Contributions

Short- and Long-Term Changes in Plasma Inflammatory Markers Associated With Preeclampsia

Dilys J. Freeman; Frances McManus; Elizabeth Ann Brown; Lynne Cherry; John Norrie; Jane E. Ramsay; Peter Clark; Isobel D. Walker; Naveed Sattar; Ian A. Greer

From the Division of Developmental Medicine (D.J.F., F.M., E.A.B., J.E.R., N.S., I.A.G.) and Department of Pathological Biochemistry (L.C., N.S.), University of Glasgow; Centre for Healthcare Randomised Trials (J.N.), Health Services Research Unit, Aberdeen University; Department of Transfusion Medicine (P.C.), Ninewells Hospital, Dundee; and Department of Haematology (I.D.W.), Royal Infirmary, Glasgow, United Kingdom.

Correspondence to Dr Dilys Freeman, Division of Developmental Medicine, Third Floor Queen Elizabeth Building, Royal Infirmary, 10 Alexandra Parade, Glasgow, G31 2ER, UK. E-mail d.freeman{at}clinmed.gla.ac.uk

Preeclampsia is characterized by hypertension, dyslipidemia, and increased systemic inflammatory response and has been associated with an increased maternal risk of cardiovascular disease later in life. Low-grade chronic inflammation is a risk factor for cardiovascular disease. This study examined changes in inflammatory markers prospectively during pregnancy, the current inflammatory status of women who had a pregnancy complicated by preeclampsia 20 years previously against matched controls, and the association between inflammatory genes and risk of preeclampsia in a case (n=106) control (n=212) study. In control pregnancies (n=34), mean interleukin-10 (IL-10) levels increased 38% (P=0.012) and tumor necrosis factor- (TNF-) by 33% (P=0.024) between the first and third trimesters. The mean preeclampsia group IL-10 and TNF- rose by 43% (P=0.013 and P=0.0065, respectively) from the first to the third trimester. In women with preeclampsia only, plasma IL-6 increased from the first to the third trimester (1.66 [2.04] to 2.94 [2.47] pg/mL; P=0.0004). Twenty years after the index pregnancy, women who had had preeclampsia demonstrated significantly higher IL-6 to IL-10 ratio (3.96 [6.07] versus 2.12 [1.89]; P=0.034) compared with a healthy index pregnancy 20 years previously, that persisted after adjustment for smoking and current body mass index. The IL-1ß (C-511T), IL-6 (G-174C), TNF- (G-308A), E-selectin (S128R), intercellular adhesion molecule-1 (K469E), and C-reactive protein (C1059G) polymorphisms were not associated with risk of developing preeclampsia. In conclusion, preeclampsia is associated with short- and long-term changes in inflammatory status.

Key Words: preeclampsia • polymorphism • cardiovascular diseases • inflammation

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