Endothelial Progenitor Cells in Umbilical Cord Blood in Preeclampsia and IUGR

The objective of this study is to determine whether there are alterations in the population of endothelial progenitor cells in umbilical cord blood samples of infants born in the setting of maternal preeclampsia or fetal growth restriction.

Study Overview

• Status: Terminated
• Conditions: Preeclampsia; IUGR

Detailed Description

Preeclampsia remains a significant cause of neonatal and maternal morbidity and mortality. This disorder is found in 5-7% of pregnancies and its incidence is increased in gravid patients with multiple gestations, chronic hypertension, renal disease, autoimmune disease, and at extremes of maternal age. It is responsible for 15% of preterm births which is accompanied by a resultant increase in neonatal morbidity and mortality. In developing countries, it is responsible for approximately 50,000 maternal deaths each year. No widespread intervention to prevent this disease has been found effective and the only effective treatment remains delivery of the fetus.

To date, the cause of preeclampsia is not known although many agree that preeclampsia is a two-stage disease as described by Roberts et al. with the placenta of central importance. The first stage involves poor placental perfusion usually a result of impaired vascular remodeling in early pregnancy or from maternal disease. This leads to the second stage, which is the maternal syndrome of preeclampsia and involves both endothelial and leukocyte activation.

Preeclampsia is associated with an increased maternal cardiovascular risk later in life. Women with a history of preeclampsia demonstrate altered expression of angiogenesis-related proteins and increased insulin resistance as measured by the homeostasis model of insulin resistance. Additionally, preeclampsia is associated with an increase in future cardiovascular risk in the fetus.

Endothelial dysfunction and abnormal regulation of vascular tone that is present in preeclampsia suggests abnormal development of vascular cells such as endothelial progenitor cells. The increased cardiovascular risk of neonates born in the setting of IUGR and preeclampsia also suggests the possibility of abnormal development of endothelial progenitor cells in the fetal compartment in these disease states. The purpose of this pilot project is to determine the effects of preeclampsia/IUGR on endothelial progenitor cells derived from fresh umbilical cord blood.

• Study Type: Observational
• Enrollment (Actual): 11

Contacts and Locations

Study Locations

• United States
  • South Carolina
    • Charleston, South Carolina, United States, 29425
      • Medical University of South Carolina

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 45 years (ADULT)
• Accepts Healthy Volunteers: Yes
• Genders Eligible for Study: Female

• Sampling Method: Probability Sample

Study Population

Pregnant women who are between 30 and 40 weeks gestation and are admitted to MUSC.

Description

Inclusion Criteria:

• Pregnant women 18-45

• Gestational age between 30-40 weeks plus:

  • Uncomplicated pregnancy or
  • Fetal estimated weight <10% for gestational age or abdominal circumference <5% or

  • Preeclampsia by ACOG criteria:

    1. HTN > 140/90 on two occasions
    2. Proteinuria > 300mg on 24 hour urine specimen or 1+ on urine dip

Exclusion Criteria:

• Non-reassuring fetal status
• Congenital abnormalities
• Multiple gestations
• Clinical Chorioamnionitis
• Recent infectious disease (within 2 weeks)

Study Plan

How is the study designed?

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort
Complicated; Women with pregnancies complicated by intrauterine growth restriction or preeclampsia
Normal; Women with normal pregnancies

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Time Frame
Proportions of endothelial progenitor cells present in umbilical cord	After birth

Collaborators and Investigators

• Sponsor: Medical University of South Carolina
• Investigators: Principal Investigator: Ashley Ryan, MD, Medical University of South Carolina

Study record dates

Study Major Dates

• Study Start (ACTUAL): March 1, 2008
• Primary Completion (ACTUAL): March 1, 2012
• Study Completion (ACTUAL): March 1, 2012

Study Registration Dates

• First Submitted: February 19, 2008
• First Submitted That Met QC Criteria: March 12, 2008
• First Posted (ESTIMATE): March 13, 2008

Study Record Updates

• Last Update Posted (ACTUAL): June 15, 2018
• Last Update Submitted That Met QC Criteria: June 13, 2018
• Last Verified: June 1, 2018

More Information

Terms related to this study

• Keywords: Endothelial dysfunction; Endothelial progenitor cells
• Additional Relevant MeSH Terms: Pregnancy Complications; Hypertension, Pregnancy-Induced; Pre-Eclampsia
• Other Study ID Numbers: HR # 17821