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Abstract: TH-PO752

Fetal APOL1 Risk Variants Association With Adverse Maternal Outcomes of Early Onset Preeclampsia

Session Information

Category: Women's Health and Kidney Diseases

  • 2100 Women's Health and Kidney Diseases

Authors

  • Fiorentino, Desiree, Montefiore Medical Center, Bronx, New York, United States
  • Hjorten, Rebecca C., University of Washington, Seattle, Washington, United States
  • Kopp, Jeffrey B., National Institutes of Health, Bethesda, Maryland, United States
  • Myrie, Joseph T., Stanford University, Stanford, California, United States
  • Reznik, Sandra E., Montefiore Medical Center, Bronx, New York, United States
  • Wang, Tao, Montefiore Medical Center, Bronx, New York, United States
  • Winkler, Cheryl Ann, National Cancer Institute, Bethesda, Maryland, United States
  • Reidy, Kimberly J., Montefiore Medical Center, Bronx, New York, United States
Background

Preeclampsia, a hypertensive disorder unique to pregnancy, has a higher incidence in women of African descent. Fetal APOL1 gene variants have been associated with increased risk of preeclampsia, but their association with maternal outcomes of preeclampsia has not been examined. We hypothesized fetal APOL1 high risk gene variants are associated with increased risk of maternal complications of preeclampsia.

Methods

Fetal APOL1 genotypes were performed in 56 mother-infant dyads affected by early onset preeclampsia diagnosed at less than 34 weeks of gestation. Births were eligible for inclusion if preeclampsia was mentioned in the placental pathology report and if the EMR identified the mother as “black or African American”. Diagnosis of preeclampsia was confirmed using ACOG criteria. Clinical data on complications was obtained from the medical record. Fisher’s exact test was performed comparing the incidence of complications in mothers with fetal APOL1 high risk variants (APOL1 G1,G1; G1,G2; or G2,G2) vs. those with fetal APOL1 low risk variants (G1,G0 or G2,G0 or G0,G0).

Results

There were no statistically significant differences in the occurrence of maternal mortality, transaminitis, coagulopathy, hepatic hematoma, Glascow coma score <13, stroke, visual disturbances, dialysis, postpartum hemorrhage, placental abruption, thrombocytopenia, blood transfusion, myocardial ischemia, eclampsia, pulmonary edema, intubation or oxygen supplementation for more than one hour amongst the two groups. There was a significant increase in the rate of acute kidney injury in mothers with preeclampsia with fetal APOL1 HR variants (p= 0.035). While there was no difference in the risk of having at least one complication, the composite score obtained as the sum of all complications experienced showed a trend towards greater complications for the fetal APOL1 HR group with a mean number of complications of 2.7 vs 1.4. This difference did not reach statistical significance (p-value 0.16). (OR 1.45, 95% CI -0.6-3.2).

Conclusion

Rate of AKI in patients diagnosed with early onset preeclampsia was higher in women with fetal APOL1 high risk alleles. The overall number of complications trended higher in this group, although it did not reach statistical significance.

Funding

  • Other NIH Support