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Hypertension

Poster Session 3

(870) MicroRNAs as Markers of Aspirin Response and Pregnancy Outcome in High Risk Singletons

Wednesday, February 14, 2024
8:30 AM – 10:00 AM  
Location: Prince George's Exhibit Hall CDE, Lower Atrium Level
Objective: Aspirin decreases the risk of preeclampsia and preterm birth in high risk pregnancies, but individual response to aspirin varies and has not been correlated with outcomes. MicroRNAs (miRNA) are non-coding RNAs that regulate gene expression. Circulating miRNAs are associated with aspirin response and cardiovascular risk in non-pregnant adults, and placental miRNAs with preeclampsia and preterm birth. We sought to evaluate selected miRNAs associated with platelet activity and preeclampsia/preterm birth to determine whether they are markers of response to aspirin in pregnancy and predictors of adverse outcomes

Study Design:

This is a prospective study of singletons at high risk for preeclampsia taking aspirin daily. Blood was drawn at baseline prior to aspirin (10-16 weeks’), 2-4 weeks after aspirin initiation (follow-up 1), and at 28-32 weeks’ (follow-up 2). PFA-100 epinephrine closure time (PFA-100 (epi)) is a known marker of aspirin response that increases with platelet inhibition. miRNAs (16, 18a, 181a, 126, 155, 223) were quantified in highly purified platelets and reported as fold-change from baseline. Pearson correlation coefficient was used to correlate PFA-100(epi) and miRNA fold change. Regression analysis was used to correlate fold-change in miRNAs and outcome of preeclampsia and preterm birth.

Results:

Of N=130 participants in parent study, N=57 had sufficient sample for miRNA extraction and reliable, reproducible quantification. At follow up-1, an increase in PFA-100(epi) was associated with a reduced miRNAs 223 (r=-0.33, p=0.017), 18a (r=-0.29, p=0.035), and 181a(r=-0.28, p=0.046). No miRNA at follow up-1 was associated with outcomes. At follow up-2, increased miRNA 223 was associated with preterm birth (B=6.5 (1.5-27.2), p=0.01) but not preeclampsia (B=2.0 (0.7-6.3, p=0.22).

Conclusion:

MicroRNAs are markers of both aspirin response in pregnancy and adverse pregnancy outcome. Platelet derived miRNA 223 has been associated with platelet activity and activation of inflammatory pathways, and is a promising marker for both tracking aspirin response and prediction of adverse pregnancy outcome.