# Apolipoprotein L1 variants and risk of preeclampsia and preterm birth in African American women

> **NIH NIH R21** · BOSTON UNIVERSITY MEDICAL CAMPUS · 2021 · $304,352

## Abstract

PROJECT SUMMARY/ABSTRACT
The proposed study will be the first large prospective study from a general population of African American (AA)
women to address a critical unknown—whether the moderately common mutations only observed among
individuals of recent African ancestry, apolipoprotein L-1 (APOL1) variants, are associated with increased risk
of preeclampsia and/or preterm birth among AA women, a population that disproportionally suffers from both
conditions. Despite the well-known excess burden and deaths in AA women from preeclampsia and preterm
birth, our current understanding of genetic predisposition to preeclampsia and preterm birth is rudimentary.
Common coding variants in the apolipoprotein L-1 gene have been shown to be very strong risk factors for a
spectrum of kidney disease in AAs. These risk variants on chromosome 22 are highly prevalent in people from
Sub-Saharan Africa, an area with the highest rate of preeclampsia and preterm birth worldwide. Several
studies in basic science support a potential role of APOL1 in the etiology of preeclampsia and the
pathophysiology of preterm birth. However, results of human studies on APOL1 genotype with risk of
preeclampsia and preterm birth are conflicting and have relied on relatively small samples with conflicting
results. Epidemiological evidence from a generalized population of AA women with sufficient statistical power
is urgently needed to fill the knowledge gap of whether APOL1 genotype predisposes AA women to a higher
risk of preeclampsia and preterm birth. We propose to test these hypotheses in a large prospective cohort of
AA women from across the United States, the Black Women's Health Study (BWHS). The BWHS has 25 years
of longitudinal data, with repeatedly collected information on pregnancy, birth outcomes, lifestyle factors, and
medical history, in addition to biospecimen samples collected from 29,601 women. APOL1 genotype data are
already available for 9,355 BWHS participants. We propose to additionally genotype 1,052 samples from
women with preeclampsia and will use a 2:1 matched case-control study design to test our hypothesis.
Findings from this study will add new insights on the complex pathophysiology of preeclampsia and preterm
birth among AAs, and help to identify early risk indicators for pregnancy complications. The huge disparity in
maternal morbidity and mortality experienced by AA women must be addressed. The proposed study has the
potential to provide information that can be used to inform earlier detection and possible prevention of certain
pregnancy complications.

## Key facts

- **NIH application ID:** 10196602
- **Project number:** 1R21HD105201-01
- **Recipient organization:** BOSTON UNIVERSITY MEDICAL CAMPUS
- **Principal Investigator:** Shanshan Sheehy
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $304,352
- **Award type:** 1
- **Project period:** 2021-05-01 → 2023-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10196602

## Citation

> US National Institutes of Health, RePORTER application 10196602, Apolipoprotein L1 variants and risk of preeclampsia and preterm birth in African American women (1R21HD105201-01). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10196602. Licensed CC0.

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