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Can you explain the "two year window"?

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Can you explain the "two year window"?

Postby vit9109 » Thu Jul 07, 2011 11:47 am

by vit9109 (39 Posts), Thu Jul 07, 2011 11:47 am

Hi Ladies,
Can someone please explain the "two year window" after having pre-e with your first pregnancy?
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Re: Can you explain the "two year window"?

Postby caryn » Thu Jul 07, 2011 02:17 pm

by caryn (10171 Posts), Thu Jul 07, 2011 02:17 pm

I think the whole idea of a "two year window" is something that popped up only on this forum - as I cannot find any serious references to it in the literature. I would not worry that you must become pregnant within a certain timeframe to exploit it.

The idea is this: when a placenta implants, it remodels the uterine spiral arteries, making them broader and less responsive to the signals that constrict blood vessels. This area of the uterus is then easier for subsequent placentas to implant into, making it more likely that subsequent pregnancies will be ones where the placenta has implanted to a normal depth, and thus less likely to become preeclamptic.

The _New Yorker_ article in my .sig talks about this in more detail.
Science! The articles you don't want to miss:
The Preeclampsia Puzzle (New Yorker) and Silent Struggle: A New Theory of Pregnancy (New York Times)
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DS Oscar born by emergent C-section at 34 weeks for fetal indicators, due to severe PE
DD Bridget born by C-section after water broke at 39 weeks after a healthy pregnancy
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Re: Can you explain the "two year window"?

Postby flori » Thu Jul 07, 2011 03:08 pm

by flori (225 Posts), Thu Jul 07, 2011 03:08 pm

Hi Caryn, I tried pulling up The New Yorker article, but didn't have any luck. Would I be able to find it elsewhere?

I can click on the link to the thread, but not the actual article itself.
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Mommy to Gracie- born at 25 weeks 03/15/11, 11 inches, 1.1lbs, and absolutely beautiful. Became my sweet angel the next day.
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Re: Can you explain the "two year window"?

Postby caryn » Thu Jul 07, 2011 03:28 pm

by caryn (10171 Posts), Thu Jul 07, 2011 03:28 pm

Ah, they had changed the link - try it now!
Science! The articles you don't want to miss:
The Preeclampsia Puzzle (New Yorker) and Silent Struggle: A New Theory of Pregnancy (New York Times)
Looking for recent articles and studies? Lectures from researchers?
A chance to participate in research? For us on Facebook or Twitter?

Caryn, @carynjrogers, who is not a doctor and who talks about science stuff *way* too much
DS Oscar born by emergent C-section at 34 weeks for fetal indicators, due to severe PE
DD Bridget born by C-section after water broke at 39 weeks after a healthy pregnancy
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caryn
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Re: Can you explain the "two year window"?

Postby steffthomas » Thu Jul 07, 2011 03:28 pm

by steffthomas (79 Posts), Thu Jul 07, 2011 03:28 pm

Not that this will help much-but I have heard of a 5 year window--That if you have a baby within 5 years of having P/E, your chances are lower of having it again
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Re: Can you explain the "two year window"?

Postby caryn » Thu Jul 07, 2011 03:36 pm

by caryn (10171 Posts), Thu Jul 07, 2011 03:36 pm

Yeah, I think people like putting a number on how long those spiral arteries will stay remodeled. But a) I'm sure it's a bell curve with a ton of individual variation because the trophoblastic cells that are doing this remodeling are highly variable in humans and b) I seriously doubt anyone has randomized populations to this, because there is no way for you to be randomly assigned to get pregnant within two years or else within more than two years and not, um, notice that you weren't in the placebo group.
Science! The articles you don't want to miss:
The Preeclampsia Puzzle (New Yorker) and Silent Struggle: A New Theory of Pregnancy (New York Times)
Looking for recent articles and studies? Lectures from researchers?
A chance to participate in research? For us on Facebook or Twitter?

Caryn, @carynjrogers, who is not a doctor and who talks about science stuff *way* too much
DS Oscar born by emergent C-section at 34 weeks for fetal indicators, due to severe PE
DD Bridget born by C-section after water broke at 39 weeks after a healthy pregnancy
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caryn
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Re: Can you explain the "two year window"?

Postby steffthomas » Thu Jul 07, 2011 05:20 pm

by steffthomas (79 Posts), Thu Jul 07, 2011 05:20 pm

Has anyone heard of the same father theory? That if the baby has the same father as baby with the p/e pregnancy, that your chances are lowered? Just another thing I've read/heard!
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Re: Can you explain the "two year window"?

Postby flori » Thu Jul 07, 2011 09:43 pm

by flori (225 Posts), Thu Jul 07, 2011 09:43 pm

I've read about that. Something about father's DNA being introduced to mommy via baby and it being good for subsequent pregnancies because the "foreign" DNA has already been there. Clearly I am no scientist. ;)
Flori, 30
Mommy to Gracie- born at 25 weeks 03/15/11, 11 inches, 1.1lbs, and absolutely beautiful. Became my sweet angel the next day.
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Re: Can you explain the "two year window"?

Postby flori » Thu Jul 07, 2011 09:44 pm

by flori (225 Posts), Thu Jul 07, 2011 09:44 pm

Also, thanks Caryn. The link works now.
Flori, 30
Mommy to Gracie- born at 25 weeks 03/15/11, 11 inches, 1.1lbs, and absolutely beautiful. Became my sweet angel the next day.
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Re: Can you explain the "two year window"?

Postby caryn » Fri Jul 08, 2011 11:03 am

by caryn (10171 Posts), Fri Jul 08, 2011 11:03 am

Yeah, that partner thing is sort of an early understanding of what was going on too. They used to worry more about primapaternity - first exposure to the partner - until the data came out showing that the problem was more likely exposure to a partner carrying HLA-C, which is to say a lot of people. The problem is really that we're making babies with other humans. :D On top of that, a lot of women develop preeclampsia because of underlying predispositions to overreact to pregnancy inflammation, and partner specifics won't matter so much for them - and the rest of us would benefit from spiral artery remodeling regardless.

Here's a link to the most recent abstract I can find on these topics. It says The risk of recurrent preeclampsia is inversely related to gestational age at the first delivery: 38.6% for 28 weeks' gestation or earlier, 29.1% for 29-32 weeks, 21.9% for 33-36 weeks, and 12.9% for 37 weeks or more. The recurrent preeclampsia risk was fairly constant if both births occurred within 7 years. Obese and overweight women had higher risks of recurrent preeclampsia (19.3% and 14.2%), compared with women with normal BMI (11.2%). The recurrence risk did not differ according to paternity status.
Science! The articles you don't want to miss:
The Preeclampsia Puzzle (New Yorker) and Silent Struggle: A New Theory of Pregnancy (New York Times)
Looking for recent articles and studies? Lectures from researchers?
A chance to participate in research? For us on Facebook or Twitter?

Caryn, @carynjrogers, who is not a doctor and who talks about science stuff *way* too much
DS Oscar born by emergent C-section at 34 weeks for fetal indicators, due to severe PE
DD Bridget born by C-section after water broke at 39 weeks after a healthy pregnancy
User avatar
caryn
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Posts: 10171
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