18 Mar Dr. Jennifer McIntosh Awarded CTSI Pilot Grant
Along with Drs. Jacquelyn P. Kulinski and Nicole Lohr, Dr. Jennifer McIntosh has been awarded the Clinical & Translational Science Institute (CTSI) Traditional Pilot Award on “Effects of Preeclampsia and Preterm Birth on Maternal Endothelial Function”.
Preeclampsia (PreE) is a disease during pregnancy in which women develop hypertension and proteinuria in previously normotensive women. It is a leading cause of maternal and fetal morbidity and mortality, affecting up to 7% of pregnancies. Until recently, the sequelae of preeclampsia were believed to resolve at delivery, however, increasing evidence suggests that women with a history of PreE are at increased risk of future cardiovascular complications. It is estimated they experience a three- to six-fold increased risk of developing hypertension and a two-fold risk for ischemic heart disease and stroke. Therefore, this topic is of significance to the cardiovascular health of over 300 million women worldwide.
The pathophysiology of PreE as a cardiovascular risk determinant remains elusive. We have found that placental vessels in women with PreE exhibit endothelial dysfunction, and there is evidence of maternal endothelial dysfunction in preeclamptic women themselves that may represent a link between PreE and cardiovascular disease later in life. However, the longitudinal changes in maternal endothelial function after delivery remain undefined. In this prospective, observational study, we leverage a multidisciplinary group of basic and translational physician scientists from Cardiovascular Medicine and Maternal Fetal Medicine to study preeclamptic women and their placentas to identify maternal and placental characteristics associated with vascular dysfunction, progression and recovery in the post-partum period.
This project will:
- Aim 1a: To evaluate how vascular and cardiac function differs at delivery and 3 months post-partum in healthy pregnancies compared to women with severe PreE with preterm delivery and preterm delivery alone.
- Aim 1b: To evaluate the impact of maternal factors on changes in vascular function post-partum.
- Aim 2: To evaluate the impact of placental damage on severity of disease and vascular function post-partum. The delivered placenta represents an accumulation of maternal and fetal insults which occur in pregnancy.
This one year grant will start April, 2019.