Obstetrics & Gynecology · 2 h ago
Mendelian randomization links maternal blood pressure and BMI to pre-eclampsia
A two-sample Mendelian randomization analysis of 22 risk factors and genetically proxied antihypertensive drug targets found associations between higher maternal BMI and blood pressure and several pre-eclampsia outcomes. Genetically proxied calcium channel blocker effects were associated with lower odds of some outcomes, but the findings do not establish that prescribing these drugs prevents pre-eclampsia.
- Higher BMI and blood pressure were associated with all PE outcomes.
- Genetic proxies for calcium channel blockers linked to lower PE odds.
- Genetic drug-target findings do not establish preventive treatment effects.
Researchers used published genome-wide association study summary statistics in a two-sample Mendelian randomization analysis to assess 22 risk factors and genetic proxies for beta-blockers and calcium channel blockers. Outcomes were pre-eclampsia (PE), PE or other maternal hypertension (PE-HTP), and PE or delivery of a small-for-gestational-age neonate (PE-SGA). Sensitivity analyses included MR-Egger, weighted median, MR-PRESSO, multivariable MR and colocalization where appropriate.
Higher genetically predicted BMI, systolic blood pressure (SBP) and diastolic blood pressure (DBP) were associated with all three outcomes. For PE, the reported odds ratios were 1.50 for BMI, 2.74 for SBP and 2.33 for DBP. Associations were also reported for PE-HTP and PE-SGA. The association between age at menarche and PE-HTP was mediated by BMI. Genetically proxied calcium channel blockers were associated with lower odds of PE and PE-HTP in DBP-based analyses; findings were consistent in complementary SBP-based analyses.
These genetic analyses suggest potential causal relationships, but do not show that treatment with calcium channel blockers prevents pre-eclampsia. The reported drug effects are based on genetic proxies, not a clinical trial of medication use during pregnancy. The study used previously published summary statistics and reported no direct study funding or competing interests.
In practice
The analysis links genetically predicted maternal BMI and blood pressure to pre-eclampsia and related outcomes, and reports lower odds of PE and PE-HTP with genetically proxied calcium channel blocker effects. This is not evidence that prescribing calcium channel blockers during pregnancy prevents these outcomes: the study used genetic proxies and summary statistics, not a treatment trial. The findings therefore do not establish a change in medication choice or preventive practice.
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BMC Medicine: The association of risk factors, circulatory biomarkers and antihypertensive medications with preeclampsia: a Mendelian randomisation analysis ↗This is an automated AI-condensed summary that has not yet been reviewed by an editor. Always consult the full item at the original source.