Contribution of maternal-fetal adrenomedullin polymorphism to gestational hypertension and preedampsia - gene-gene interaction pilot study

Introduction: Adrenomedullin (ADM), a peptide with vasodilatory natriuretic and diuretic properties, is secreted in many tissues and shows multidirectional activity ADM activity may play an important role in the pathophysiology of gestational hypertension (GH) and preedampsia (PE) by involvement in compensation of failed utero-placental unit circulation. Aim of the study: The aim of the study was to evaluate the association of -1984A>G ADM gene polymorphism with the development of GH and PE in maternal-fetal dyads. Materials and methods: The study group consisted of 46 hypertensive pregnant subjects (further divided into two subgroups: 20 pregnant women with GH and 26 women with PE). 43 healthy pregnant women constituted the control group. The study and the control groups as well as the newborns were genotyped for -1984A>G ADM gene polymorphism using PCR/RLFP procedures. Results: Minor -1984G allele was found to be higher in both, the GH (15.00%, OR=3.62, p=0.05), and the PE groups (9,62, OR=2.18, p=ns) when compared with controls (4.65%). A tendency for higher frequency of minor -1984G allele (12.50 vs. 6.98% in controls, OR=1.91, p=ns) was observed in the newborns from the GH group. It was also noteworthy that coexistence of both heterozygous genotypes of maternal-fetal dyads (-1984AG mother/-1984AG fetus) was overrepresented in the GH group (15.00 vs. 6.98%, OR=2.35, p=ns) and in the PE group (11.54 vs. 6.98%, OR= 1.74, p=ns) when compared to controls. Conclusions: The observed tendency for overrepresentation of minor -19840 ADM allele in the GH and PE women and their newborns, despite lack of statistical significance, suggests participation of this genetic variant in the pathogenesis of the mentioned conditions. Additionally the obtained results could indicate that maternal-fetal gene-gene interaction may be a potential source of adverse perinatal outcomes.