New Yorker: The Preeclampsia Puzzle

[mar1nka]

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

[blythe]

Thank you! [:D]

[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]

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.

[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".

[taras mom]

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

[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![;)]

[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?

[laura]

One more thing- your friendly voice from tobacco control would like to remind everyone that regardless of how great it might ulitimately prove to the placenta, smoking while pregnant is *not* a good idea. Babies subjected to smoking moms have problems with the development of their lungs, SIDS, and it has even been associated with an estimated 1/3 of kids with ADD.

As someone subjected with prenatal exposure to smoking and SHS exposure as a child, I can say that the ADD I have and reactive airway disease/asthma isn't worth it.

[caryn]

And on that note, Karumanchi just mentioned in passing that this therapy would first be tried in non-pregnant humans, to see what other systems are affected, to see if it's even tenable as a therapy for expectant management. If we can give it to non-pregnant people without serious compromise, then we can test it in pregnant people, and see if it actually does help the mother without harming the fetus, or if it helps the fetus too, or if it doesn't allow any further prolongation of pregnancy.

(Whee, this conference is fun!)