Postpartum alterations in circulating endothelial progenitor cells in women with a history of pre-eclampsia

ObjectiveTo characterize persistent postpartum maternal endothelial dysfunction following pre-eclampsia (PE) through the assessment of endothelial progenitor cells as markers of endothelial reparative capacity.Study designMaternal circulating endothelial progenitor cells were measured at 2 months and 6 months postpartum in women who had recently experienced PE pregnancies (n = 17). Normotensive controls (n = 13) with uncomplicated pregnancies served for comparison at the same time points. Progenitor cells were measured by flow cytometry and by colony forming units. Maternal cardiovascular risk was measured at 6 months postpartum.Main outcome measuresLevels of maternal circulating endothelial progenitor cells and cardiovascular risk in the early postpartum period of uncomplicated and PE pregnancies.ResultsCD34 + VEGFR-2+ and CD133 + VEGFR-2+ cells were elevated in PE subjects at 2 months postpartum compared to healthy control subjects, although reduced by 6 months postpartum. PE was associated with reduced colony forming units at 2 and 6 months postpartum. Cardiovascular risk scores were increased in PE compared to normotensive controls.ConclusionsWe have demonstrated that there is a physiological alteration in the number and function of circulating progenitor cells following PE pregnancies. Furthermore, this population of women exhibited elevated cardiovascular risk profiles compared to those with uncomplicated pregnancies. Pregnancy and the development of PE identify an early window for cardiovascular risk screening in women. Cellular markers of vascular health offer an approach to the investigation of postpartum endothelial dysfunction.