Fetal APOL1 kidney risk alleles are associated with increased risk for preeclampsia in African Americans and maternal fetal genotype discordance is also associated with this risk.
Preeclampsia, characterized by increased blood pressure after 20 weeks of pregnancy, as well as other abnormalities (e.g., protein in the urine), is dangerous to mothers and their infants. Previous studies found that individuals with African ancestry may carry APOL1 genetic variants that increase risk for chronic kidney disease. This study published in the American Journal of Kidney Diseases (AJKD) found that fetal high-risk APOL1 genotypes and maternal-fetal APOL1 genotype discordance independently contribute to preeclampsia risk in African-American mothers. This association was not observed in Haitian mother-infant pairs possibly because of different environmental exposures and cultural milieu. Additional studies are required to understand why APOL1 associations with preeclampsia differ by maternal country of origin and to improve management of mothers at risk for preeclampsia.