Inflammatory and Haemostatic Changes Following Pre-eclampsia: Potential Link with Development of Subsequent Cardiovascular Events?

Pre-eclampsia (P-EC) is a major cause of maternal and neonatal mortality and morbidity. Despite intensive research, its aetiology remains poorly understood. However, underlying maternal cardiovascular risk factors are thought to be implicated. Changes in the maternal vasculature and coagulation profile may predispose women with P-EC to subsequent adverse cardiovascular consequences. Here we investigate the relationship between circulating levels of haemostatic factors and inflammatory cytokines in women with a previous history of P-EC. The participents included 26 women who had had P-EC within the last three years and were more than 6 months postpartum and 14 age-matched healthy women with no past history of P-EC. Blood was collected and assayed for plasma IL-6, IL-8, TNF-α and IL-10, Tissue Factor (TF) and TF-Pathway Inhibitor (TFPI), using Enzyme-Linked Immunosorbent Assays. Individually, plasma TF, IL-6, IL-8 and IL-10 levels increased in the P-EC group compared with their normal counterparts, whereas plasma TFPI and TNF-α level were reduced. Plasma TF/TFPI ratios and IL-10 values were significantly increased in the P-EC group compared with controls (p<0.05, p<0.01, respectively). There were positive and significant correlations between TFPI and IL-10 (r= 0.5; p<0.01) and TF/TFPI ratio and IL-10 (r= 0.31; p<0.041), and between IL-6 and TNF-α (r=0.71; p<0.001) and IL-6 and IL-10 (r=0.42; p<0.01). In conclusion, our results suggest the presence of elevated inflammatory cytokines and an imbalance of the haemostatic system in women with a past-history of P-EC, which may contribute to the known increased risk of cardiovascular disease in these women later in life.