The Adverse Impact of Pregestational Prediabetes Contributes to HELLP Syndrome Development

Introduction: Both preeclampsia (PE) and prediabetes (PD) are known hypertensive disorders of pregnancy, and a correlation has been shown between these two diseases. A recent study in our laboratory has shown that pregestational PD is a risk factor for developing PE during pregnancy, as pregestational PD increased antiangiogenic factors. However, pregestational PD antiangiogenic release has not been shown to be associated with liver dysfunction. Therefore, this study seeks to investigate pregestational PD as a risk factor for hemolysis, elevated liver enzymes, and low platelet (HELLP) syndrome. Materials and Methods: Animals were divided into a normal pregnant group (ND), a preeclamptic pregnant group (PE), and a prediabetic pregnant group (PD). On gestational day (GND) 19, animals were sacrificed, and blood and liver tissues were collected to measure antioxidant protection and lipid peroxidation parameters, liver TGs, liver enzymes, TNF-α, IL-6, and hematology parameters. Results: The results showed significant increases in liver TGs, liver enzymes, TNF-α, IL-6, and hematology parameters in the PE and PD pregnant groups compared to the ND group. Conclusions: These findings suggest that pregestational PD predisposes patients to metabolic and inflammatory changes associated with HELLP syndrome. To our knowledge, this is the first study to demonstrate a link between pregestational PD and HELLP syndrome-related complications in a preclinical model, highlighting the importance of monitoring metabolic health before pregnancy.