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Phoa K.Y.N.,University of Amsterdam | Chedraui P.,High Risk Pregnancy Labor and Delivery Unit | Chedraui P.,University of Guayaquil | Perez-Lopez F.R.,University of Zaragoza | And 4 more authors.
Journal of Obstetrics and Gynaecology | Year: 2016

Preeclampsia in Ecuador is an understudied subject since available epidemiological data are scarce. The aim of this study was to describe perinatal outcomes among singleton pregnancies complicated with preeclampsia and eclampsia in a sample of low-income Ecuadorian women. Pregnant women complicated with preeclampsia (mild and severe) and eclampsia (defined according to criteria of the ACOG) delivering at the Enrique C. Sotomayor Obstetrics and Gynecology Hospital, Guayaquil, Ecuador were surveyed with a structured questionnaire containing maternal (socio-demographic) and neonatal data. Perinatal outcomes were compared according to severity of clinical presentation. A total of 163 women with preeclampsia [mild (23.9%), severe (68.7%) and eclampsia (7.4%)] were surveyed. Perinatal mortality and stillbirth rate was similar among studied groups (mild vs. severe preeclampsia/eclampsia cases). However, severe cases displayed higher rates of adverse perinatal outcomes: lower birth Apgar scores, more preterm births, and more low birth weight and small for gestational age infants. Caesarean-section rate and the number of admissions to intensive or intermediate neonatal care were higher in severe cases. A similar trend was found when analysis excluded preterm gestations. In conclusion, in this specific low-income Ecuadorian population perinatal outcome was adverse in pregnancies complicated with severe preeclampsia/eclampsia. © 2016 Informa UK Limited, trading as Taylor & Francis Group.


Chedraui P.,Enrique C. Sotomayor Obstetrics and Gynecology Hospital | Chedraui P.,Catholic University of Santiago de Guayaquil | Salazar-Pousada D.,Enrique C. Sotomayor Obstetrics and Gynecology Hospital | Villao A.,Enrique C. Sotomayor Obstetrics and Gynecology Hospital | And 5 more authors.
Gynecological Endocrinology | Year: 2014

Objective: To determine the prevalence of C677T and A1298C Single-nucleotide polymorphisms (SNPs) of the MTHFR gene in nulliparous women complicated with preeclampsia (PE). Methods: One hundred fifty gestations complicated with PE and their corresponding controls without the disease were recruited for the genotyping of C677T and A1298C polymorphisms of the MTHFR gene using restriction fragment length polymorphism polymerase chain reaction. Secondarily, homocysteine (HCy) plasma levels were measured in preeclamptic women displaying the CC genotype of the A1298C polymorphism (homozygous) and compared to HCy levels determined among controls with the normal AA genotype for the A1298C variant. Results: Only the mutant CC genotype of the A1298C polymorphism was associated to higher risk of presenting PE, as frequency of this genotype was significantly higher among cases than controls (15.3% versus 0.7%, p<0.05). All PE women with a neck circumference ≥32cm presented the mutant CC A1298C polymorphism as compared to none among preeclamptics with a lower neck circumference (p=0.0001). Women with the mutant CC A1298C SNP displayed higher plasma HCy levels as compared to controls with normal AA A1298C genotype (8.4±2.6 versus 7.5±2.7mmoL/L p=0.04). Conclusion: Prevalence of the CC mutant genotype of the A1298C polymorphism was higher among PE women. This mutation among PE women was related to increased neck circumference and higher HCy levels. Future research should aim at linking these gestational findings with obesity and cardiovascular risk. © 2014 Informa UK Ltd. All rights reserved: reproduction in whole or part not permitted.


Chedraui P.,Enrique C. Sotomayor Obstetrics and Gynecology Hospital | Chedraui P.,Catholic University of Santiago de Guayaquil | Andrade M.E.,Enrique C. Sotomayor Obstetrics and Gynecology Hospital | Salazar-Pousada D.,Enrique C. Sotomayor Obstetrics and Gynecology Hospital | And 9 more authors.
Gynecological Endocrinology | Year: 2015

Background: Preeclampsia has been related to single-nucleotide polymorphisms (SNPs) of the methylenetetrahydrofolate reductase (MTHFR) gene; however, data regarding the placenta are still lacking.Objective: To determine the frequency of C677T and A1298C SNPs of the MTHFR gene in the placenta of preeclamptic pregnancies and healthy controls.Methods: Genotyping of C677T and A1298C polymorphisms of the MTHFR gene using RFLP-PCR was performed to the placenta of 100 gestations (n = 50 complicated with preeclampsia and n = 50 normal controls matched for parity and maternal age).Results: Gestational age at birth and neonatal and placental weight were significantly lower in women with preeclampsia as compared to controls. The TT genotype of the C677T polymorphism was threefold more prevalent in preeclamptic placentas as compared to the placenta of controls (24.0% versus 8.0%, p = 0.001). Upon pooled analysis (n = 100), placental and neonatal weights were significantly lower in placentas displaying this genotype (TT, C677T) as compared with the CC genotype.Conclusion: This study found that the frequency of the TT mutant genotype of the C677T polymorphism was higher in the placenta of pregnancies complicated with preeclampsia. There is a need for further research in this matter. © 2015 Informa UK Ltd. All rights reserved: reproduction in whole or part not permitted.

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