Uncovering the metabolic clues of preeclampsia
Scientists have uncovered metabolic patterns linked to the severity of preeclampsia, a leading cause of maternal-fetal mortality.
A recent Brazilian study published in PLOS One has revealed that distinct blood metabolite patterns correlate with the severity of preeclampsia, potentially unlocking new strategies for early diagnosis and intervention. Using nuclear magnetic resonance spectroscopy to establish the metabolomic profiles of pregnant women, this research has revealed important insights into the link between metabolites and disease progression.
Preeclampsia is a serious pregnancy complication marked by high blood pressure and organ damage to the kidneys, liver, lungs and brain. According to the World Health Organization (Geneva, Switzerland), preeclampsia is a major cause of maternal and fetal deaths worldwide and can affect 2–10% of pregnancies. In Brazil, this number is vastly disproportionate, with 37% of maternal deaths resulting from obstetric complications linked to preeclampsia.
The only cure for preeclampsia is to deliver the baby or monitor the condition until it is possible to deliver the baby, often leading to premature births. Unfortunately, we still don’t know the exact cause of preeclampsia, which makes it difficult to develop alternative medical treatments. Researchers from Brazil and Portugal sought to address this knowledge gap by uncovering the altered metabolomic landscapes in maternal plasma during hypertensive (high blood pressure) pregnancies.
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The team began by analyzing blood samples from 173 pregnant women categorized as healthy, having gestational hypertension, preeclampsia or severe preeclampsia. Using hydrogen nuclear magnetic resonance spectroscopy and subsequent bioinformatics analysis, they identified 19 associated metabolites, with 11 showing significant variations between groups.
They discovered that patients with severe preeclampsia had elevated levels of metabolites such as N,N-dimethylglycine, alanine, valine and creatine, compared to patients with less severe preeclampsia. These molecules were linked to higher blood pressure and poorer organ function, reinforcing the role of metabolic alterations in disease progression.
Notably, the research was the first to use hydrogen nuclear magnetic resonance spectroscopy for identifying metabolic changes in preeclamptic patients, a technique that offers precise molecular insights without altering the samples. These findings suggest that metabolic disturbances worsen with the severity of preeclampsia, providing insights into the disease’s impact on kidney, liver and brain function.
“In our investigation of what happened to the metabolism in these women, we succeeded in showing not only that it was altered but also that the patterns of alteration correlated with clinical variables. This is important because it opens up possibilities of a better understanding of preeclampsia, especially with regard to organ damage,” explained Valeria Cristina Sandrim, a Professor at São Paulo State University’s Botucatu Institute of Biosciences (IBB-UNESP; Brazil).
The team plan to investigate why these metabolic disruptions occur and whether pharmacological interventions can correct them. Additionally, they aim to identify early biomarkers of preeclampsia by analyzing blood samples from pregnant women before diagnosis. This could enable early detection and more effective management of at-risk pregnancies, especially in regions with limited maternal healthcare resources.
