Impacts Of Parental Factors On Preeclampsia And The Role Of Klotho In Preeclampsia Development

Impacts of parental factors on perrclampsaiObjective Preeclampsia is one of the major causes of maternal or fetal morbidities and mortalities, and also responsible for a great proportion of indicated preterm births worldwide. Therefore explore the maternal and paternal influencing factors would provide potential intervention clue to improve mother and fetus health. Current investigation was conducted in two Class A hospitals to collect maternal and her husband's demographic information, living habits and life style, socioeconomic status, history of chronic diseases, and also collect maternal health care, the pregnancy outcomes of pregnancy and pregnancy-specific diseases, to identify the contributions of parental factors to preeclampsia and low birth weight, provide theoretical data and practice support to reduce the incidence of adverse pregnancy outcomes, and to improve the quality of pregnancy.Methods This study recruited women who deliver in the Hubei Provincial People's Hospital and Central South Hospital and her husband during the period of Jan 1st 2013 to Dec 31st 2014. Maternal and paternal basic information, socioeconomic status, life style, and maternal health care before and during pregnancy, the pregnancy outcomes. A total of 2300 pairs of questionnaires were distributed, and finally 1721 pairs of questionnaires were analyze by SPSS20.0 software, and the effective rate is 74.8%. The comparisons of maternal and paternal demographic information, socioeconomic status, life style, history of diseases, pregnancy outcome between normal pregnancy and pregnant women with preeclampsia were performed using student t test and chi square test depend on the data characteristics. Second, univariate and stepwise multivariate logistic regression were conducted by setting preeclampsia or birth weight as a dependent variable.Results The prevalence rate of preeclampsia in these two hospitals is 7.6%. From maternal point of view, multivariate logistic regression showed that age, prepregnant BMI, prepregnant hypertension, father and mother hypertension, family location, education and check-up frequency during pregnancy. Advance age (OR= 1.046,95%CI 1.001-1.093,0.047), higher prepregnant BMI (OR=1.094,95%CI 1.038-1.152), previous hypertension (OR=1.579,95%CI 1.270-1.963,0.001), father (OR=1.747,95%CI 1.099-2.776,0.018) or mother (OR=1.888,95%CI 1.207-2.889, 0.005) hypertension are independent risk factors for women to develop into preeclampsia, and live in provincial city(OR=0.852,95%CI 0.736-0.985,0.030), more educated (OR=0.700,95%CI 0.575-0.851,0.000) and more frequent check-up during pregnancy (OR=0.617,95%CI 0.500-0.763,0.000) are independent protective factor against women to develop into preeclampsia. Form paternal point of view, less educated and smoking habits contributed significantly to their partner's preeclampsia. The average gestational week in preeclampsia group is shorter than that of normal pregnancy, therefore, it is reasonable that higher incident rate of low birth weight was observed in neonatal with preeclampsia mother. However, it should be noted that preeclampsia women also had higher incident rate of macrosomia. To find out the influencing factor of neonatal birth weight, we set low birth weight or macrosomia as independent variable and analyzed the contribution from maternal or paternal factors. From maternal point of view, multivariate logistic regression showed that gestational age, gestational weight gains, preeclampsia and family location were independent variables for low birth weight. Woman with preeclampsia, short gestational week, lower gestational weight gains and live in the rural area are most likely to deliver a low birth weight baby. From paternal point of view, live in a provincial city is a protective factor of low birth weight. For macrosomia, multivariate regression of maternal factors revealed that woman with advance age, higher parity, higher prepregnant BMI, longer gestational week and higher gestational weight gains more likely to deliver a macrosomia baby. However, we did not observe paternal effects on macrosomia.Conclusion Both maternal and paternal factors contribute to preeclampsia development and also exert high impact on fetal birth weight.The role of Klotho in preeclampsia development Objective Klotho is recently discovered new protein,and rich in human placenta.Klotho exerts protective effect on vascular system through suppressed oxidative stress which produce by pregnancy and cKfoK has the pokntial be erapeutic intervention in e management of preeclampsia. Preeclampsia,diagnosed by newly onset hypertensioth and proteinuria after 20 weeks of gestation is a major contributor to maternal and neonatal morbidity and mortality worldwide. Preeclampsia not only causes a multisystem disorder botii mother and fetus, it also predisposes em both future cardiovascular diase and other disorders. Therefbre,the protective role of klotho on endothelial flmctioth make it a potential target for preeclampsia.Method With the consent of recruked women, we collect embryonic samples from abortion at early, middle and late stage of pregnancy during 2014.1 2015.6 in Renmin Hospital of Wuhan University. At 1;he same time period, we recruked preeclampsia and normal pregnancy women and collect basic and clinical information. The routine blood and urea t:ests were done upon admission. Maternal serum was collecd upon admission.Maternal serum secret;ed k]o?o were measured by ELISA and the potential predictive ability fbr preeclampsia were analyzed by ROC. Klotho mRNA and proin expression in placenta were measured by realtime RT-PC,immunohistochemistry and western blot, and the potential signaling pathway of NFkB was also explored.Results Klooprotein expreion in early and late stage of pregnancy are highanat of middle pregnancy, although it did not reach significant level, enlarge sample size will warrant the results. ELISA showed that maternal serum klotho COthcentration was markedly lower in preeclampsia wheth compared normal pregnant women. ROC analysis show that with cut-off value of 830ng/ml,secreted klotho migh be a potential biomarker predict preeclampsia and sensitivity,specificity,and AUC were 89.5%,73.1%,and 0.796, respectivelyeal-time RT-PCR exhibited at kloo expression in placental also decline in women with preeclampsia. Western blot andimmunohistochemistry showed the same patterns in klotho expression in placental for both normal and preeclampsia women. In parallel with lower klotho level, higher phosphorylation of NFkB was observed in preeclampsia placental.Conclusion Preeclamptic pregnancy decreased klotho egression in maternal serum and placenta, and NFkB signaling pathway might involve in klotho modulation.