Contributions to genetics, immunology and nutrition in preeclampsia

Preeclampsia is a complication of human pregnancy, characterized by high blood pressure and the loss of protein in urine. In this thesis, we first describe processes during normal pregnancy, like the presence of some degree of (physiological) stress in the placenta. During a preeclamptic pregnancy, the normal stress trajectory is disturbed. The ways the placenta and the mother cope determine the final clinical symptoms of preeclampsia (Chapter 1). In the next chapters, we investigated genetic, immunological and nutritional factors that could play a role in the etiology of preeclampsia. Our study population comprised women living in Curaçao. The presence of the Duffy negative blood group proved associated with preeclampsia. Two other genetic risk factors (MTHFR C677T and C282Y HFE) proved unassociated. We found indications (e.g. increased interleukine-8) that the low-grade inflammatory response as seen in normal late pregnancies is more intense in preeclamptic pregnancies. We found lower levels of the so called “long-chain polyunsaturated fatty acids” (LCP) of the w3-series (LCPw3, notably in marine-based animal food products) and the w6-series (LCPw6) in umbilical vessels of preeclamptic pregnancies. These LCP are important for fetal brain development. A consecutive supplementation study with healthy pregnant women showed that low doses LCPw3 (500, 1000 mg per day) were able to increase the LCPw3 content of umbilical vessels. Finally, we found indications that the nutrient betaine plays an important role in the so-called one-carbon metabolism during normal pregnancy