HDP is the most common cardiometabolic complication of pregnancy, affecting nearly 10% of US pregnancies. In the US, women of African American race are at increased risk for HDP. Early biomarkers that reliably identify women at risk for HDP remain elusive yet are essential for the early identification and targeting of interventions to improve maternal and infant outcomes. We employed HRM to identify metabolites and metabolic pathways that researchers altered in early gestation serum samples of pregnant African American women who developed HDP after 20 weeks’ gestation—either preeclampsia or gestational hypertension—compared to those who delivered full term without complications. We found four metabolic pathways that researchers significantly altered in women who developed PE. Five courses changed considerably in women who grew gHTN compared to women who delivered full term without complications. These findings support systemic metabolic disruptions that are detectable in early pregnancy (8-14 weeks of gestation) among pregnant African American women who develop PE and gHTN. Furthermore, the early pregnancy metabolic disruptions associated with PE and gHTN are distinct, implying they are unique entities rather than conditions along a spectrum of the same disease process despite the common clinical feature of high blood pressure.
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