First-trimester maternal renin-angiotensin-aldosterone system activation and the association with maternal telomere length after natural and IVF/ICSI conceived pregnancies: the Rotterdam periconception cohort

Figures & data

Table 1. Baseline characteristics of the virtual placenta study population.

Characteristics	Total group (n = 145)	Missing
Maternal age (y)	32.37 ± 4.5	0
Conception mode		0
Natural	84 (57.9)
IVF/ICSI	61 (42.1)
Nulliparous	65 (44.8)	0
Ethnicity		4
Dutch	114 (8.9)
Western	6 (4.3)
Non-Western	21 (14.9)
Educational level		4
Low	12 (8.5)
Intermediate	46 (32.6)
High	83 (58.9)
BMI at study entry (kg/m^2)	24.86 [22.38, 27.99]	0
MAP (mmHg)	79.95 [72.60, 87.30]	4
Folic acid supplement use (yes)	120 (82.8)	4
Alcohol consumption, preconception	39 (26.9)	0
Smoking, preconception	16 (11.0)	0

Data are presented as mean (standard deviation), median (interquartile range) and number of individuals (percentages). BMI = body-mass index; MAP = mean arterial blood pressure.

Figure 1. Correlations by Spearman Rank test between maternal telomere length (T/S ratio) and a) renin, b) prorenin, c) aldosterone.

Table 2. The associations between first-trimester log-transformed RAAS component concentrations at week 9 of pregnancy and telomere length at 20 weeks of pregnancy.

	Crude		Model 1		Model 2
	Estimate (β), (95% CI)	p-value	Estimate (β), (95% CI)	p-value	Estimate (β), (95% CI)	p-value
Renin	−0.094 (−0.17; −0.01)	0.023*	−0.092 (−0.17; −0.01)	0.025*	−0.086 (−0.17; −0.00)	0.047*
Prorenin	−0.069 (−0.14; −0.00)	0.060	−0.065 (−0.14;0.01)	0.079	−0.058 (−0.13; 0.02)	0.142
Aldosterone	−0.014 (−0.07;0.05)	0.640	−0.010 (−0.07; 0.05)	0.734	−0.002 (−0.07; 0.07)	0.937

Model 1: Adjusted analysis for maternal age.

Model 2: Fully adjusted for maternal age, conception mode, pre pregnancy body-mass index, mean arterial blood pressure, smoking status.

*Significance at p < 0.05.

Figure 2. Box-and-whisker plot demonstrating the distribution of telomere length (TS ratio) in the natural conceived group compared with the IVF/ICSI group. Boxplots present median, 10th, 25th, 75th, and 90th percentile. Telomere length was compared by Mann-Whitney U test. *Significance at p < 0.05.

Figure 3. Box-and-whisker plot demonstrating the distribution of renin, prorenin and aldosterone concentrations in the natural conceived group compared with the IVF/ICSI group. Boxplots present median, 10th, 25th, 75th, and 90th percentile. Renin, prorenin and aldosterone concentrations were compared by Mann-Whitney U test. *Significance at p < 0.05.

Data availability statement

The data that support the findings of this study are available from the corresponding author, DAF, upon reasonable request.