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Supporting data values - hemoglobin EVERREST paper.xlsx (22.36 kB)

Research data for a study on haemoglobin and heme defences - "EVERREST" study

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posted on 2024-06-10, 14:47 authored by Adam Brook, Georgia Baynes, jonathan scargill, Angelos Evangelinos, Charlotte Brennan-Richardson, Freya Dow, Yuval Ginsberg, Tal Weissbach, Janna Brodszki, Eva Hansson, Anke Diemert, Kurt Hecher, Katarzyna Maksym, Neil Marlow, Rebecca Spencer, Anna DavidAnna David, Stefan Hansson, Paul BrownbillPaul Brownbill

Background: Unregulated elevations of free plasma fetal hemoglobin (HbF) are observed in fetal growth restriction (FGR) at term and preeclampsia; both conditions are associated with altered long-term trajectories of cardiovascular and brain development. Objectives: To assess fetal circulating HbF levels and heme defences, correlated to fetal circulatory biometry and fetal sex in severe early-onset fetal growth restriction. Methods: In a prospective study of pregnancies with severe early-onset FGR (the EVERREST study; estimated fetal weight <3rd centile and <600g at 20-26+6 weeks of gestation; N=20) with close clinical management, free HbF and the heme-scavengers hemopexin, haptoglobin and alpha-1 microglobulin, were quantified in cord blood. Results were compared with data from normal non-FGR term births (N=26) and births with late-onset FGR (N=12) for comparison. Results: Free HbF was elevated in early FGR deliveries compared with normal pregnancy (P<0.0001). Pregnancies with male fetuses had higher HbF levels after early FGR compared with normal non-FGR male births at term (P<0.001). Hemopexin-mediated clearance was significantly blunted in both early- and late-onset FGR groups compared with normal births (P<0.0001). In EVERREST, antenatally-derived ratios of mid-cerebral artery and umbilical artery pulsatility indices correlated positively with heme-scavenger levels (hemopexin and a heme-handling composite measure: P<0.01), indicating lower levels are associated with cerebral vascular redistribution, itself linked to earlier delivery and lower birthweight. Conclusion: Free HbF overproduction may be one route to placental vascular compromise in early-onset FGR.

Funding

Ameliorating the detrimental endothelial effects of free fetal haemoglobin in fetal growth restriction using hydroxychloroquine.

Wellbeing of Women

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Does vascular endothelial growth factor gene therapy safely improve outcome in severe early-onset fetal growth restriction?

European Commission

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Haemoglobin, globin and iron in preeclampsia and fetal growth restriction

Swedish Research Council

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History

Research ethics approval number

13/LO/1254, 08/H1010/05, 18/NW/0451, 15/NW/0829

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