New Yorker: The Preeclampsia Puzzle

[sweetiesuzy]

I had the same reserve when I first read about that in the article. I have seen lots of bad outcomes because of smoking during pregnancy (nicotine) exposure etc. I would think that would be a lot of testing down the road - if ever?

[jacobdaniel]

I guess I was oversimplifying things.[:I] Thanks Caryn and Catherine for you more in depth explanation...I think I get it now, you gals are so smart![;)]

[taras mom]

Smoking and second-hand smoke also increase the risk of miscarriage.

[lil_gramma_deb]

This is a very interesting article. Carbon Monoxide is found in cigarettes and is mentioned in this article. After reading it I had remembered reading something recently I had found online when searching for PE stuff about carbon monoxide being suggested as a possible treatment for PE. It seems a Dr. Smith from Queens University has just submitted to carry out a study to confirm the findings clinically. Google search for "carbon monoxide" and "preeclampsia".

[blythe]

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=15533604&dopt=Abstract

Direct placental effects of cigarette smoke protect women from pre-eclampsia: the specific roles of carbon monoxide and antioxidant systems in the placenta

-article from 2004 that notes "Interestingly, women who smoke cigarettes throughout pregnancy are at a 33% reduced risk of developing pre-eclampsia" but goes on to say "While smoking cigarettes has been shown to ‘protect’ women from developing PE, the harmful effects outweigh any potential benefit they provide against this disorder."

The article also says "In fact, women who smoke and who subsequently developed PE have a much poorer outcome than non-smoking women who develop PE" (and references C. Salafia and K. Shiverick, Cigarette smoking and pregnancy II: vascular effects, Placenta 20 (2004), pp. 273–279. for that statement) -- so smoking may be protective against developing the disease in the first place, but if you do smoke and get PE, you might get it MUCH WORSE.

Caryn I'd love to read the speculation on PE and Neanderthals! I just saw an article recently about low blood pressure being related to stillbirth -

http://www.contemporaryobgyn.net/obgyn/article/articleDetail.jsp?id=378052

I wonder if there's a natural selection reason for PE then: somewhat higher BP in pregnancy protects the baby from stillbirth - one reason why PE hasn't been selected against and disappeared, even with the mortality for untreated mom and baby.

[caryn]

Heather,

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=AbstractPlus&list_uids=12896818&query_hl=5&itool=pubmed_docsum

It seems to me that many of the symptoms of PE are actually associated with better survival rates -- otherwise the genes that cause the effects wouldn't have been selected *for*, and we wouldn't see them...

[blythe]

Thank you! [:D]

[mar1nka]

Fascinating article - I'm glad to see that people are taking him seriously now, and that he is so dedicated to this research.

[lisainnj]

Some investigators are looking into the possibility that too much oxygen in the first trimester can cause PE later - the placenta is then normally a low O2 environment with the spiral arteries mostly plugged. CO replaces O2 in hemoglobin and is hard to get rid of - perhaps once it gets into the placenta it leaves very slowly and offers some protection in placentas where the spiral arteries are not sufficiently plugged?

CO also seems to protect against damage caused by re-oygenation after hypoxia - wondering if women who get PE tend to have bigger swings in BP to cause many re-oxygenation/hypoxia cycles.

[clark6122]

This isn't exactly related to the thread per se, but I know there are related studies being conducted.

I know because when I went to the MFM on Monday he asked me if I'd like to join the study. My MFM is the principal investigator. They will be testing my urine and blood about 5 times during the pregnancy and at delivery. I know it won't help me, but if it can help other women to not have PE I'm all for it.

Lynn