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Preeclampsia Doubles Stroke Risk
The estimated 7 million women in the United States today who experienced a hypertensive disorder of pregnancy should be aware of new guidelines for preventing stroke in women from the American Stroke Association. We have known for many years that a history of preeclampsia during pregnancy puts women at greater risk for future high blood pressure, but continuing research shows that the impact may extend to stroke risk, as well. In the U.S., stroke is now more common in women than men, with more than half of the 795,000 strokes that occur each year happening to women. The disease is also more deadly in women, with about 60 percent of stroke deaths happening in female patients.
" Guidelines for the Prevention of Stroke in Women - A Statement for Healthcare Professionals" from the American Heart Association and American Stroke Association were issued last week. These first-time-ever guidelines, similar to a 2011 publication by the American Heart Association, declared preeclampsia as a significant risk factor for heart disease and stroke. This paper suggested preeclampsia survivors have double the risk of having a stroke and those who developed preeclampsia before 32 weeks, a five-fold increased risk, over women with normal pregnancies. The guidelines went even farther to recommend interventions to prevent preeclampsia, in the hopes that improved pregnancy outcomes would lower a woman's risk of stroke.
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LETTER FROM THE EXECUTIVE DIRECTOR
3 New Findings that Could Change Preeclampsia Care
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Two weeks ago we were in New Orleans at the Society for Maternal-Fetal Medicine annual meeting, awaiting the results of the HYPITAT II study, and learned - probably to no one's surprise - that expectant monitoring is recommended over immediate delivery for women with pregnancy-related hypertension between 34 and 37 weeks.
The first HYPITAT* study - widely heralded for the size of the population it studied and therefore strength of its results - produced a somewhat controversial recommendation. Its findings suggested we should bail out of all pregnancies affected by pregnancy-related hypertension (e.g., preeclampsia, gestational hypertension) at 37 weeks, noting better outcomes for both mother and baby. This "immediate delivery" protocol has now been included in most management guidelines, though it is not without its critics. (*We love our acronyms, don't we? HYPITAT stands for Hypertension and Preeclampsia Intervention Trial At Term, and was a multi-center, randomized controlled trial in the Netherlands.)
This second study - HYPITAT II - reported at The Pregnancy Meeting™ - found that, for hypertensive mothers between 34 and 37 weeks of pregnancy, postponing delivery until the baby is no longer at risk for breathing difficulties, or until mother or child become too severely ill to wait any longer, produces better outcomes than immediate delivery. The challenge, of course, is defining "too severely ill" in a disorder that is often characterized by a constellation of symptoms. That, and the fact that preeclampsia can turn severe and life-threatening in a matter of hours, makes expectant management (i.e., monitoring) challenging for all but the most experienced obstetricians. Nonetheless, these findings indicated that taking a monitored "wait and see" approach may be the best practice for better outcomes.
In addition to this oral presentation during the opening plenary session, it was encouraging to see over 80 other talks and poster presentations on the topic of preeclampsia. Low dose aspirin is still being researched with results supporting both sides of the decision to offer this intervention for possible prevention of preeclampsia; quite a bit of mechanistic research was presented (i.e., the molecular "cause" of preeclampsia); and much more.
The scientific questions surrounding this complex disorder of pregnancy continue to intrigue and motivate researchers, which was heartening to see. More discouraging is what appears to be the snail's pace and lack of large-scale clinical trials that are needed to move forward what we actually need to do for our preeclamptic women.
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HEARD ON THE HILL by Julie Allen
Cautious Optimism for Medical Research Funding for 2014
 On January 17, President Obama signed an omnibus federal funding (appropriations) bill into law, thus continuing funding for all government agencies through September 30, 2014 and averting another government shutdown. Included in the bill as a result of intense negotiations was a reduction in cuts to scientific programs, including medical research, which can be viewed as a small victory and offering hope for medical research funding in the years to come.
The National Institutes of Health (NIH), the largest provider of federally-funded medical research, received $29.9 billion, which equates to $1 billion increase over levels from fiscal year 2013. The NIH National Institute of Child Health and Human Development, where the majority of preeclampsia-related research is conducted will receive approximately $1.3 billion. NIH funding doubled between FY 1998 and FY 2003, but since that time has seen a 25 percent reduction in overall funding.
Since passage of the federal funding legislation, House Republican leadership have expressed a desire to work to increase funding to the NIH over the coming years. NIH visibility was certainly elevated last fall during the government shutdown when media reports showed that the closure of the government prevented 200 patients, some of them children, from having access to the NIH Clinical Center to address rare diseases and incurable conditions. The House leadership has expressed a desire to lower funds from programs deemed "less priority" so funds can continue to be reprogrammed for medical research going forward.
The interest in elevating funding for NIH is met with cautious optimism by patient advocates and medical researchers. NIH and individual NIH Institute funding levels are determined each federal fiscal year by Congress, and how the funding is prioritized and directed to address specific diseases and conditions is determined by the individual Institute directors. The Preeclampsia Foundation continues to support the growth of NIH research that will advance the clinical understanding of preeclampsia and result in improved management of the disease and eventually a cure.
Editor's Note: Julie Allen represents the Preeclampsia Foundation's interests in Washington, DC.
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Foundation Website Upgrade Coming Soon!
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 Did you know that more than 60% of www.preeclampsia.org 1.3 MILLION unique website visitors come to our site from mobile devices? Our website is the heartbeat of our organization and we know we need to meet patients where they are.
So, we are excited to announce a mobile website upgrade coming soon! The Preeclampsia Foundation website will be undergoing an upgrade to our basic operating platform which includes improved security and a few design modifications that we hope will be pleasing to the 1.3 million unique visitors we host each year at www.preeclampsia.org. You'll still find all the same great content, but with easier "findability." Login names and passcodes will all remain the same.
We'll also be unveiling an offshoot to our current website that will deliver our most popular and important content in Spanish. This decision was based on the need to better serve our Spanish-speaking US population who represent a particularly vulnerable group for moms and babies at risk of serious adverse outcomes from preeclampsia, as well as to be a resource to the growing number of international visitors from Latin American countries where preeclampsia is the #1 cause of maternal mortality. This online deployment accompanies our recent production of Spanish language patient education materials.
No doubt there will be a few hiccups as we roll out website version 3.0, despite months of development and testing. We ask for your patience as well as your constructive feedback. Please email webmaster@preeclampsia.org with specific concerns or technical difficulties you may encounter.
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Top 3 Reasons to Register Early
 It's that time of year again: registration is open and supporters of The Promise Walk for Preeclampsia(™) are gearing up to "Make Strides and Deliver Hope!" Many walkers wait till late in the season to register their teams, but here are 3 GREAT reasons to get your registrations in today.
- Bigger team spirit
- Guaranteed t-shirt
- Higher fundraising results which translates to bigger impact on our shared mission to save lives and improve pregnancy outcomes.
Not convinced? Have a better reason to register early. Discuss here.
Find a Promise Walk near you or support the Virtual Walk.
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Honoring a Great Man:
John Warner (1954-2014)
 It is with heavy heart that the Foundation recognizes the sudden loss of one of our own, John Warner. Since his daughter Shelly's death in 2005, John has been a relentless champion for patient and provider education, and for advancing research to make a difference for other young mothers. He left no stone unturned, opened many doors, and together with his equally motivated family and strong Iowa community raised over $200,000 toward this mission. You can learn more about the Warner's contributions in our 2009 tribute video.
The staff, board members, and volunteers of the Preeclampsia Foundation loved John and drew enormous inspiration from him. If you have any special thoughts or reflections you would like to share, please post a message on our Facebook page.
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Research Funding Available NOW!
The Preeclampsia Foundation announced a call for applications for the 2014 Vision Grants. These $25,000 research grants are intended to fund novel ideas for preeclampsia research that will advance patient care. Details and applications available here.
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The Giving Library, an online video archive that connects donors to nonprofits, is giving a total of $20,000 to nonprofits in the month of February.
This is a way for you to support the Preeclampsia Foundation by simply raising awareness. All you have to do is share our Giving Library video this month, and the Giving Library will donate $5 to us. It's that simple! Participants can share up to five organizations per month, and the Giving Library will donate up to $20,000 during the campaign. How to Share: 1. Sign up at the Giving Library. (All you need is an email address!) 2. Visit the Preeclampsia Foundation Giving Library page. 4. Click "Share Now" and share the video on Facebook or Twitter. (Share either the default message or a message of your choice.) 6. The organization will receive $5 per share. 7. Individuals may share up to five organizations per month.
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Fetal Medicine Foundation of Latin America Annual Meeting
Miami, Florida February 20, 2014
Florence, Italy
March 26-29, 2014
Chicago, IL
April 26-30, 2014
Minneapolis, MN
April 26, 2014
Toronto, CAN
May 14-18, 2014
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Improving Healthcare Practices Depends on Evidence
The evidence to support changes in healthcare practices is derived from data. To move this research forward, the Preeclampsia Foundation launched The Preeclampsia Registry on September 9, 2013. To date over 500 people have enrolled in the registry and begun entering their pregnancy history and other data in response to easy-to-use online questionnaires.
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2014 Volunteer Hours
Our volunteers have
reported a total of
445
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