Pre-eclampsia is a serious condition of late pregnancy that is characterised by high blood pressure and proteinuria in the second-half of pregnancy. Pre-eclampsia affects 5% of first time mothers and is associated with significant maternal and neonatal morbidity and mortality. Suspected pre-eclampsia is the most frequent clinical presentation to obstetric day-care units in Ireland. Despite intense research efforts the cause of pre-eclampsia has remained an enigma. Nonetheless it is now accepted that the placenta plays a crucial role in the development of pre-eclampsia. Placental dysfunction can provoke a systemic inflammatory response which contributes to the development of pre-eclampsia. Furthermore women with pre-eclampsia have exaggerated insulin resistance which is a key instigator of hypertension during pregnancy. One common denominator related to increases in both inflammation and insulin resistance is elevated maternal BMI. Women who are overweight or obese at the beginning of pregnancy are at a significantly increased risk of developing pre-eclampsia. This may in part be related to the adverse effects of adiposity on maternal metabolism and inflammation. We hypothesise that maternal BMI is a contributing factor leading to increased inflammation and insulin resistance in pre-eclampsia. The primary aim of this study to quantify systemic inflammation and insulin resistance in pre-eclampsia. Secondly, in this study we will explore if placental inflammation contributes to systemic maternal inflammation. Finally, we will correlate maternal BMI with these biological mediators in pregnancy to elucidate if a causal role exists in pre-eclampsia. Thus this project will establish if modifying maternal BMI during pregnancy may reduce the risk of developing pre-eclampsia.
