Influences of environmental factors during preeclampsia

Abstract

Preeclampsia is a pregnancy-specific disorder that impacts 5-8% of pregnancies and has long-term cardiovascular and metabolic implications for both mother and fetus. The mechanisms are unclear; however, it is believed that preeclampsia is characterized by abnormal vascularization during placentation resulting in the manifestation of clinical signs such as hypertension, proteinuria, and endothelial dysfunction. Although there is no current cure to alleviate the clinical signs, an emerging area of interest in the field is the influence of environmental factors including diet on the risk of preeclampsia. Because preeclampsia has serious cardiovascular implications to both the mother and fetus and most antihypertensive medications are contraindicated in pregnancy, it is important to investigate other potential therapeutic options such as dietary manipulation. The emerging field of nutrigenomics links diet with the gene expression of known pathways such as oxidative stress and inflammation via microbiome-mediated metabolites and could serve as one potential avenue of therapeutic targets for preeclampsia. Although the exact role of nutrition in the pathogenesis of preeclampsia is unknown, this review will focus on known pathways involved in the development of preeclampsia and how dietary intake modulates the microbiome, oxidative stress, and inflammation with an emphasis on nutrigenomics as a potential avenue of further investigation to better understand this pathology.

Keywords: diet; inflammation; microbiome; nutrigenomics; oxidative stress; preeclampsia.

Fig. 1.

Proposed pathway linking diet with the development of preeclampsia based on studies cited within this review. Specific dietary intake alters the risk of preeclampsia through interrelated mechanisms beginning with adaptations in microbiota composition and metabolites. These alterations can have implications on gene expression of known pathways such as oxidative stress and inflammation that could modify function of these pathways, which ultimately can influence the risk of developing preeclampsia.