Determinants of Maternal Renin-Angiotensin-Aldosterone-System Activation in Early Pregnancy: Insights From 2 Cohorts.
Adult
Aldosterone
/ blood
Anti-Mullerian Hormone
/ blood
Body Mass Index
Corpus Luteum
/ metabolism
Embryo Transfer
Estradiol
/ blood
Female
Fertilization in Vitro
Humans
Ovulation Induction
Pregnancy
Pregnancy Trimester, First
/ blood
Progesterone
/ blood
Prospective Studies
Renin
/ blood
Renin-Angiotensin System
/ physiology
corpus luteum
in vitro fertilization
preeclampsia
pregnancy
prorenin
renin-angiotensin-aldosterone-system
Journal
The Journal of clinical endocrinology and metabolism
ISSN: 1945-7197
Titre abrégé: J Clin Endocrinol Metab
Pays: United States
ID NLM: 0375362
Informations de publication
Date de publication:
01 11 2020
01 11 2020
Historique:
received:
19
08
2020
accepted:
26
08
2020
pubmed:
28
8
2020
medline:
17
2
2021
entrez:
28
8
2020
Statut:
ppublish
Résumé
The corpus luteum (CL) secretes prorenin, renin's inactive precursor. It may thus contribute to the renin-angiotensin-aldosterone-system (RAAS) activation that is required for maternal adaptation in pregnancy. Whether this activation is disturbed in pregnancies lacking a CL is unknown. The objective of this work is to investigate maternal RAAS determinants in early pregnancy. Two observational prospective cohort studies. 2 tertiary referral hospitals. Pregnancies (n = 277) were stratified by CL number and in vitro fertilization (IVF) protocol: 0 CL (programmed cycle frozen embryo transfer [FET], n = 28), 1 CL (natural cycle FET, n = 41 and spontaneous conceptions, n = 139), and more than 1 CL (ovarian stimulation and fresh embryo transfer, n = 69). Quantification was performed for maternal prorenin, renin, and aldosterone blood levels at 5, 9, and 11 weeks of gestation. Prorenin and renin were lower in the absence of a CL at all time points when compared to 1 CL, whereas prorenin, renin, and aldosterone were higher in the presence of more than 1 CL vs 1 CL (P < .05). Ovarian stimulation with menopausal gonadotropin resulted in higher prorenin, renin, and aldosterone concentrations during the late first trimester than recombinant follicle-stimulating hormone (P < .05). Prorenin, and to a lesser degree renin, correlated positively with serum progesterone and relaxin, but not serum estradiol. Total follicle diameter, body mass index (BMI), polycystic ovary syndrome (PCOS), and antimüllerian hormone (AMH) were additional determinants of circulating prorenin. Finally, pregnancies conceived in the absence of a CL were more disposed to develop preeclampsia. CL number, IVF protocol, BMI, PCOS, and AMH affect maternal RAAS activation in early pregnancy, and may thus contribute to pregnancy complications.
Identifiants
pubmed: 32853347
pii: 5898239
doi: 10.1210/clinem/dgaa582
pmc: PMC7494245
pii:
doi:
Substances chimiques
Aldosterone
4964P6T9RB
Progesterone
4G7DS2Q64Y
Estradiol
4TI98Z838E
Anti-Mullerian Hormone
80497-65-0
Renin
EC 3.4.23.15
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Subventions
Organisme : NICHD NIH HHS
ID : P01 HD065647
Pays : United States
Organisme : NCATS NIH HHS
ID : UL1 TR001085
Pays : United States
Organisme : NCATS NIH HHS
ID : UL1 TR003142
Pays : United States
Informations de copyright
© Endocrine Society 2020. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
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