Early-onset preeclampsia : Constitutional factors and consequences for future pregnancy outcome and cardiovascular health

Abstract

In this thesis, maternal constitutional factors related to long-term cardiovascular health and subsequent pregnancy outcome in women with early-onset preeclampsia is addressed. Aims of the thesis: To evaluate subsequent pregnancy outcome in women with a first pregnancy complicated by early-onset preeclampsia and to study risk factors for recurrence of preeclampsia and preterm delivery; To evaluate subsequent pregnancy outcome in women with a first pregnancy complicated by intrauterine growth restriction without maternal hypertensive disease; To characterize classic cardiovascular risk factors predictive of first cardiovascular events in primiparous women with a history of early-onset preeclampsia; To estimate global risk of major cardiovascular events in primiparous women with previous early-onset preeclampsia; To evaluate a novel circulating marker for ischemia, ischemia modified albumin (IMA), in normal pregnancy and preeclampsia; To provide a comprehensive review of previous studies on inflammatory; changes in preeclampsia, with emphasis on current understanding of the maternal innate and adaptive immune response; To study the role of allelic variants of the innate immunity receptors; Toll-like receptor 4 (TLR4) and nucleotide-binding oligomerization domain 2 (NOD2) and plasma inflammatory biomarkers in women with previous early onset preeclampsia; To evaluate the maternal acute-phase inflammatory response to influenza vaccination, as a model for mild in vivo stimulation of the immune system, in women with a history of early-onset preeclampsia.