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Predisposition to superimposed preeclampsia in women with chronic hypertension: endothelial, renal, cardiac, and placental factors in a prospective longitudinal cohort

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Kate Bramham, Pia M Villa, Jennifer R Joslin, Hannele Laivuori, Esa Hämäläinen, Eero Kajantie, Katri Räikkönen, Anukatriina Pesonen, Paul Seed, R Neil Dalton, Charles Turner, Max Wong, Peter Von Dadelszen, James M Roberts, Lucilla Poston, Lucy C Chappell

Original languageEnglish
Pages (from-to)326-335
Number of pages10
Issue number3
Early online date1 Jun 2020
E-pub ahead of print1 Jun 2020
Published2 Jul 2020

King's Authors


OBJECTIVE: To assess the contribution of maternal and placental factors to the development of superimposed preeclampsia in women with chronic hypertension.

METHODS: Endothelial and renal function markers were serially assessed in 90 pregnant women with chronic hypertension and controls.

RESULTS: Syndecan-1 concentrations were lower at 26-27+6 weeks in women with chronic hypertension who subsequently developed superimposed preeclampsia compared with those who did not. Decreased PlGF and raised urine albumin:creatinine ratio were also associated with development of superimposed preeclampsia.

CONCLUSION: Decreased syndecan-1 and PlGF concentrations implicate endothelial glycocalyx disturbance and reduced placental angiogenic capacity, respectively, in the pathophysiology of superimposed preeclampsia.

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