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Research into preeclampsia and its relationship to the long-term health of mother and baby reveals both good news and a caution for preeclampsia survivors.
Evidence is unequivocal now that women who have experienced preeclampsia, particularly severe or early onset preeclampsia, are at a significantly increased risk for cardiovascular problems later in life compared to women with a history of healthy pregnancies. The "take home lesson" for preeclampsia survivors is to establish a healthy lifestyle (weight loss, exercise, no smoking) and to discuss cardiovascular assessment and follow up with your health care provider.
"There are very few identified risk factors for later life heart disease in women; preeclampsia is one of the few warning signs we'll get and we should take advantage of it," explained Executive Director Eleni Tsigas.
One study demonstrated that women who have a history of preeclampsia experienced an increased risk of cardio-vascular health hazard equivalent to that of someone who has smoked for much of her life. That is the bad news.
As Dr. James Roberts reported at the Preeclampsia Foundation Patient Symposium, October 2009, "There is also some good news!" Although not all studies agree, most have shown a reduced risk of breast cancer in women who have had preeclampsia, as much as 15-20% lower risk, with the largest reductions in pregnancies with boy babies.
Dr. Anne Gingery of the Department of Physiology and Pharmacology at the University of Minnesota Medical School in Duluth has investigated how specific factors released from the placenta of women with preeclampsia inhibit the growth of breast cancer cells. Her research focuses on two factors released during preeclampsia: sFlt-1, a soluble version of a protein called VEGF (vascular endothelial growth factor), that regulates the growth of beta cells, and soluble endoglin, a co-receptor for transforming growth factor (TGF) beta cells. Gingery's research, looking at rat models, found placental factors released into the blood stream that may possess anti-cancer properties. She proposes that soluble endoglin inhibits cell growth by reducing the signaling of the TGF pathway, an important factor in breast cancer development and progression.
Other studies have found that breast cancer risk following preeclampsia varies by the gender of the baby delivered. A team in Norway that studied more than 700,000 women through the Cancer Registry of Norway determined that the risk of breast cancer was reduced even more if the woman delivered a son, rather than a daughter (relative risks of 0.79 vs. 0.94). If the preeclamptic pregnancy resulted in a premature birth, the risk reduction from the birth of a son or daughter grows more dramatically - by about four times. These results suggest that the effect of preeclampsia may be attributed to factors associated with the particular pregnancy rather than an underlying biological trait of the mother.
However, cautions the Foundation's medical board, a "reduced risk" does not let a woman off the hook for monthly breast self-exams and regular mammograms. "The risk is reduced, but not enough to avoid the need for awareness and diligent health care," said Roberts.
Northside Hospital CME, Atlanta, GA
August 21, 2015
7th Annual Perinatal Safety Summit, Las Vegas, NV
October 1-2, 2015