Cardiac function and preeclampsia

  • Research type

    Research Study

  • Full title

    Linking the maternal immune system to cardiac function in preeclampsia

  • IRAS ID

    281197

  • Contact name

    Suchita Nadkarni

  • Contact email

    s.nadkarni@qmul.ac.uk

  • Sponsor organisation

    Queen Mary's University of London

  • Duration of Study in the UK

    2 years, 11 months, 31 days

  • Research summary

    Research Summary

    This is a pilot clinical observational study , investigating the immune system and cardiac function in women with preeclampsia during pregnancy and postnatally.
    The study will be conducted at Barts Health NHS Trust. The study population will comprise of 3 groups of participants:

    1. Preeclamptic patients (34 patients)
    2. Pregnancy induced hypertension (33 patients)
    3. Healthy pregnant women (33 patients)

    Patients will be consented at the point at which they are diagnosed with preeclampsia. Healthy pregnant women as controls and women with pregnancy induced hypertension will be consented at gestations matched to those of the preeclamptic women. Women will be eligible if this is their first pregnancy, it is a singleton pregnancy and they are aged over 18 years.

    Participants will be asked to attend for two hospital appointments, one upon enrolment and a second at 3 months postpartum. During these appointments echocardiography and non-contrast cardiovascular magnetic resonance (CMR) studies will be carried out on all participants. Any patient within the study group who demonstrates abnormal cardiac changes at 3 months postpartum will be followed up at 6-months postpartum in the NHS. At the two appointments time matched blood samples will be taken. The blood samples will be tested to look at immune cells, hormone levels, cardiac markers, and inflammatory and non-inflammatory mediators.

    This pilot study will test the feasibility of a larger study and give new insight into how the maternal immune system influences cardiac changes in normal and preeclamptic pregnancies.

    Summary of Results

    Our overarching aim for this study was to investigate whether maternal inflammation - i.e when the white blood cells misbehave -is contributing factor to poor heart function in women who have preeclampsia and pregnancy-induced hypertension - collectively known as hypertensive (high blood pressure) disorders of pregnancy (HDP). Women with these types of pregnancy complications have heart dysfunction during pregnancy, and in some cases continues after she gives birth. However, why this post pregnancy heart dysfunction continues in some women is currently unknown.

    Our study revealed that in women with HDPs, inflammation in the mother's blood during pregnancy can be linked to cardiac dysfunction not just when she is pregnant, but it is also responsible for her heart not functioning properly postpartum (after pregnancy), providing a clear link between maternal inflammation and heart dysfunction during and after pregnancy in women who have HDPs.

  • REC name

    West Midlands - Edgbaston Research Ethics Committee

  • REC reference

    20/WM/0200

  • Date of REC Opinion

    21 Aug 2020

  • REC opinion

    Further Information Favourable Opinion