Haptoglobin Phenotype, Preeclampsia Risk and the Efficacy of Vitamin C and E Supplementation to Prevent Preeclampsia in a Racially Diverse Population

Tracey L. Weissgerber, Robin E. Gandley, Paula L. McGee, Catherine Y. Spong, Leslie Myatt, Kenneth J. Leveno, John M. Thorp, Brian M. Mercer, Alan M. Peaceman, Susan M. Ramin, Marshall W. Carpenter, Philip Samuels, Anthony Sciscione, Margaret Harper, Jorge E. Tolosa, George Saade, Yoram Sorokin

Research output: Contribution to journalArticle

13 Scopus citations

Abstract

Haptoglobin's (Hp) antioxidant and pro-angiogenic properties differ between the 1-1, 2-1, and 2-2 phenotypes. Hp phenotype affects cardiovascular disease risk and treatment response to antioxidant vitamins in some non-pregnant populations. We previously demonstrated that preeclampsia risk was doubled in white Hp 2-1 women, compared to Hp 1-1 women. Our objectives were to determine whether we could reproduce this finding in a larger cohort, and to determine whether Hp phenotype influences lack of efficacy of antioxidant vitamins in preventing preeclampsia and serious complications of pregnancy-associated hypertension (PAH). This is a secondary analysis of a randomized controlled trial in which 10,154 low-risk women received daily vitamin C and E, or placebo, from 9-16 weeks gestation until delivery. Hp phenotype was determined in the study prediction cohort (n = 2,393) and a case-control cohort (703 cases, 1,406 controls). The primary outcome was severe PAH, or mild or severe PAH with elevated liver enzymes, elevated serum creatinine, thrombocytopenia, eclampsia, fetal growth restriction, medically indicated preterm birth or perinatal death. Preeclampsia was a secondary outcome. Odds ratios were estimated by logistic regression. Sampling weights were used to reduce bias from an overrepresentation of women with preeclampsia or the primary outcome. There was no relationship between Hp phenotype and the primary outcome or preeclampsia in Hispanic, white/other or black women. Vitamin supplementation did not reduce the risk of the primary outcome or preeclampsia in women of any phenotype. Supplementation increased preeclampsia risk (odds ratio 3.30; 95% confidence interval 1.61-6.82, p<0.01) in Hispanic Hp 2-2 women. Hp phenotype does not influence preeclampsia risk, or identify a subset of women who may benefit from vitamin C and E supplementation to prevent preeclampsia.

Original languageEnglish (US)
Article numbere60479
JournalPloS one
Volume8
Issue number4
DOIs
StatePublished - Apr 3 2013

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)
  • General

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    Weissgerber, T. L., Gandley, R. E., McGee, P. L., Spong, C. Y., Myatt, L., Leveno, K. J., Thorp, J. M., Mercer, B. M., Peaceman, A. M., Ramin, S. M., Carpenter, M. W., Samuels, P., Sciscione, A., Harper, M., Tolosa, J. E., Saade, G., & Sorokin, Y. (2013). Haptoglobin Phenotype, Preeclampsia Risk and the Efficacy of Vitamin C and E Supplementation to Prevent Preeclampsia in a Racially Diverse Population. PloS one, 8(4), [e60479]. https://doi.org/10.1371/journal.pone.0060479