Cohort profile: The PreEclampsia, Angiogenesis, Cardiac dysfunction and Hypertension (PEACH) Study

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  • Lisa Kristine Grange Persson
  • Frederikke Fog Lihme
  • Saima Basit
  • Maria Oku Larsen
  • Nikolai Madrid Scheller
  • Anita Sylvest Andersen
  • Karen Green Halse
  • Annette Thorsen-Meyer
  • Karina Meden Sørensen
  • Jan Wohlfahrt
  • Mads Melbye
  • Kasper Kai Østrup Pihl
  • Lykke, Jacob Alexander
  • Heather Allison Boyd

Background: Hypertensive disorders of pregnancy (HDP) remain a leading cause of maternal morbidity and mortality worldwide, with implications for maternal and neonatal well-being in the short term and for long-term maternal cardiovascular health. Although the mechanisms behind HDP remain incompletely understood, evidence suggests that preeclampsia in particular is a syndrome with more than one distinct subtype. Objectives: The PEACH (PreEclampsia, Angiogenesis, Cardiac dysfunction, Hypertension) Study was established to identify new HDP subtyping systems reflecting aetiology and prognosis and to find markers of later cardiovascular disease risk associated with preeclampsia. Population: The PEACH Study recruited pregnant women referred to two Copenhagen-area hospitals with suspected preeclampsia (mean gestational age at enrolment: 36.7 weeks) and a group of frequency-matched pregnant women planning delivery at the same hospitals and healthy when enrolled mid-pregnancy. Design: Prospective, longitudinal pregnancy cohort. Methods: Participants underwent repeated third-trimester blood sample collection, longitudinal cardiac function assessments using the USCOM-1A during the third trimester and at 1 year postpartum and collection of placental samples immediately after delivery. Medical information was abstracted from medical records and hospital databases. Preliminary results: During 2016–2018, we recruited 1149 pregnant women, of whom 1101 were followed to delivery. Among 691 women enrolled with suspected preeclampsia, 310 and 172 developed preeclampsia and gestational hypertension respectively. Among 410 women with healthy pregnancies when enrolled mid-pregnancy, 37 later developed hypertensive disorders of pregnancy. Of 1089 women still in the cohort 1 year postpartum, 578 (53.1%) participated in the follow-up assessment. Conclusions: The PEACH Study's rich data from women with and without HDP will enable us to identify new, clinically useful HDP subtypes to aid in decision-making regarding monitoring and treatment. Continued postpartum follow-up will help us develop algorithms to identify women at risk of persistent postpartum cardiac dysfunction and later cardiovascular disease after pregnancies complicated by HDP.

OriginalsprogEngelsk
TidsskriftPaediatric and Perinatal Epidemiology
Vol/bind36
Udgave nummer6
Sider (fra-til)863-878
Antal sider16
ISSN0269-5022
DOI
StatusUdgivet - 2022

Bibliografisk note

Funding Information:
The PEACH Study's recruitment phase and 1‐year follow‐up was funded by the Danish Council for Independent Research (DFF‐4092‐00213), the Lundbeck Foundation (R194‐2015‐1226), the Toyota Foundation, the A.P. Møller Foundation for the Advancement of Medical Science (16–42) and Aase and Ejnar Danielsen's Fund (10–002049). The Novo Nordisk Foundation has provided support for analytic work and maternal kidney function examinations 5 years postpartum (NNF19OC0054286). Ph.D. students working on the project have been funded by the Danish Council for Independent Research (DFF‐4092‐00213) and the U.S. National Institutes of Health (1R01HL13984401A1). The study was conducted in collaboration with the Danish National Biobank, which was supported by the Novo Nordisk Foundation (2010‐11‐12 and 2009‐07‐28). None of the funding sources played any role in the design or conduct of the PEACH Study, in the analysis of study data or in publication decisions.

Funding Information:
We thank Medistim Danmark ApS for the loan of a second USCOM-1A device for 3 months during the study period. We acknowledge the tremendous assistance with recruitment and data collection provided by medical student Karin Lauridsen, nurse Emma Dilber Jensen, midwife Kristel Ailin Guldhaugen, intern Camilla Øst Cloos, trainee Tanja Østbø and the following students in Public Health from the University of Copenhagen and the University of Southern Denmark: Anne Brunsgaard, Line Buchwald, Amanda Gøth-Rasmussen, Vár Honnudottír, Lucca Sciera, Maria Nivi Schmidt Petersen, Blerina Rusiti and Helene Utecht. Our thanks also go to the health assistants, sonographers and midwives in the participating departments for helping us identify eligible participants and take study samples. Special thanks to midwife Anna Friis Jørgensen for her outstanding effort in recruitment and to her colleagues Mette Kabell Hansen, Mai Cecilie Juul Sørensen and Marie Stampe Emborg.

Publisher Copyright:
© 2022 The Authors. Paediatric and Perinatal Epidemiology published by John Wiley & Sons Ltd.

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