Advanced Maternal Age Impairs Uterine Artery Adaptations to Pregnancy in Rats

Wooldridge, Amy L.; Pasha, Mazhar; Chitrakar, Palehswan; Kirschenman, Raven; Quon, Anita; Spaans, Floor; Sáez, Tamara; Cooke, Christy‐Lynn M.; Davidge, Sandra T.

doi:10.3390/ijms23169191

Cited by 11 publications

(7 citation statements)

References 68 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This represents a reduced maximum capacity for blood carrying capacity and potentially less ability to compensate for impaired vascular function when needed. Previously, using a pregnant rat model for advanced maternal age, we observed reduced circumferential strain in the uterine arteries of aged pregnant (vs. younger pregnant) rats at gestational day 20 (term = 22) [ 8 ]. In the rat model, we did not observe a difference in collagen:elastin ratio in arteries from pregnant rats of different age groups; however, during the present study, we observed that arteries from women of advanced maternal age had a greater collagen:elastin ratio compared with arteries from younger women.…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies by our lab demonstrated that advanced maternal age in rats impairs both vascular function and structure. Uterine arteries from aged pregnant rats have altered circumferential stress–strain relationships, including less strain, compared with younger pregnant controls [ 8 ]. Decreased strain values, with a leftward shift of the passive circumferential stress–strain curve, indicate reduced compliance [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

“…Decreased strain values, with a leftward shift of the passive circumferential stress–strain curve, indicate reduced compliance [ 9 ]. These vascular changes were accompanied by reduced litter size, lowered fetal placental weight ratio, and increased fetal resorptions [ 8 , 10 ], linking poor vascular adaptations during pregnancy with poor pregnancy outcomes. Whether there are any potential effects on vascular stiffness in an older yet still fertile population of ‘advanced’ maternal aged women during their pregnancies is not known.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Increased stiffness of omental arteries from late pregnant women at advanced maternal age

Wooldridge

Chan

Spaans³

et al. 2023

Bioscience Reports

Self Cite

View full text Add to dashboard Cite

Advanced maternal age (≥35 years) is a risk factor for poor pregnancy outcomes. Pregnancy requires extensive maternal vascular adaptations, and with age, our blood vessels become stiffer and change in structure (collagen and elastin). However, the effect of advanced maternal age on the structure of human resistance arteries during pregnancy is unknown. As omental resistance arteries contribute to blood pressure regulation, assessing their structure in pregnancy may inform on the causal mechanisms underlying pregnancy complications in women of advanced maternal age. Omental fat biopsies were obtained from younger (<35 years) or advanced maternal age (≥35 years) women during caesarean delivery (n=7-9/group). Arteries (200-300 µm) were isolated and passive mechanical properties (circumferential stress and strain) assessed with pressure myography. Collagen (Masson’s Trichrome) and elastin (Verhoff) were visualized histologically and % positively-stained area was assessed. Median maternal age was 32 years (range 25-34) for younger, and 38 years (range 35-42) for women of advanced maternal age. Circumferential strain was lower in arteries from advanced maternal age vs. younger women but circumferential stress was not different. Omental artery collagen levels were similar, while elastin levels were lower with advanced maternal age vs. younger pregnancies. The collagen:elastin ratio was greater in arteries from advanced maternal age vs. younger women. In conclusion, omental arteries from women of advanced maternal age were less compliant with less elastin compared to arteries of younger controls, which may affect how vascular stressors are tolerated during pregnancy. Understanding how vascular aging affects pregnancy adaptations may contribute to better pregnancy outcomes.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Increased stiffness of omental arteries from late pregnant women at advanced maternal age

Wooldridge

Chan

Spaans³

et al. 2023

Bioscience Reports

Self Cite

View full text Add to dashboard Cite

show abstract

“…These increased risks in advanced maternal age could be explained by reproductive ageing, including declined uterine function and damage to the blood and endocrine system [ 25 ]. Studies have also shown that older pregnancies are associated with uterine atherosclerosis, impaired uterine myometrial contractility, changes in blood volume, vascular endothelial injury, decreased oxytocin receptors, and insulin receptor dysfunction [ 26 , 27 ].…”

Section: Discussionmentioning

confidence: 99%

Dose-response associations of maternal age with pregnancy complications and multimorbidity among nulliparas and multiparas: A multicentric retrospective cohort study in southern China

Li,

Duan

et al. 2023

J Glob Health

View full text Add to dashboard Cite

Background Advanced maternal age is becoming an increasingly common issue worldwide, presenting substantial health risks to pregnant women. However, dose-response associations of maternal age with a comprehensive range of pregnancy complications and their multimorbidity remain unclear. Methods We conducted a retrospective cohort study using data from China’s National Maternal Near Miss Surveillance System for 2017-2018, including 18 hospitals in southern China. We included 135 274 pregnant women aged 15-54 years with a singleton birth. We used multivariable logistic regression and restricted cubic spline to examine dose-response associations between maternal age and various pregnancy complications, as well as multimorbidity. We employed the Apriori algorithm to mine the association rules among pregnancy complications and identify frequent multimorbidity patterns. Results We found three distinct patterns of associations between maternal age and specific pregnancy complications. In relation to increasing maternal age, gestational diabetes mellitus, preeclampsia, and gestational hypertension showed nonlinear increasing trends for both nulliparas and multiparas, as did multimorbidity in nulliparas. Conversely, we observed linear increasing trends for placental previa in both nulliparas and multiparas, placental abruption in nulliparas, and multimorbidity in multiparas. Infection and severe anaemia had an approximate J-shaped curve among nulliparas, while postpartum haemorrhage exhibited a similar curve in both nulliparas and multiparas. Advanced maternal age was linked to an elevated risk of multimorbidity during pregnancy or postpartum period, exhibiting more complicated patterns. The most common multimorbidity patterns in this age group were “preeclampsia + gestational diabetes mellitus”, “gestational hypertension + gestational diabetes mellitus”, “infection + gestational diabetes mellitus”, and “placental previa + gestational diabetes mellitus”. Conclusions Maternal age was associated with pregnancy complications and multimorbidity in three broad dose-response manners, including approximate J-shaped curves, as well as nonlinear and linear increasing trends, depending on the specific outcome and parity, which may suggest different underlying biological mechanisms. Women with advanced maternal age had a higher risk and more complicated patterns of multimorbidity during pregnancy or postpartum, suggesting that this group should be targeted for more intensive health care.

show abstract

“…In a previous preclinical study, these same authors reported that circumferential strain of uterine arteries isolated at the end of pregnancy was lower in aged pregnant rats compared with young pregnant rats. However, they found no differences in strain between young non-pregnant and aged non-pregnant rats, mediated by matrix metalloproteinase dysregulation of elastin and collagen and enhanced myogenic vascular tone, leading to reduced vascular compliance [ 24 , 25 ]. These data suggest that decreased elastin content and circumferential strain at term reflects cardiovascular maladaptation to pregnancy in AMA, rather than a baseline effect of aging.…”

Section: Commentarymentioning

confidence: 99%

Commentary on: Increased stiffness of omental arteries from late pregnant women at advanced maternal age

Stanhewicz,

Schwartz,

Lee

2023

Bioscience Reports

View full text Add to dashboard Cite

Worldwide, pregnancy at age 35 or older, termed “advanced maternal age”, is increasing exponentially. As the incidence of pregnancy at advanced maternal age has increased, a growing body of evidence has suggested that advanced maternal age is also associated with increased risk for adverse maternal and fetal outcomes outside of genetic anomalies. Importantly, despite the mounting evidence and the increased global risk of adverse perinatal outcomes observed, few studies have examined the potential mechanisms underlying this elevated risk in pregnant people ≥35 years of age. Wooldridge and colleagues begin to address this gap in the literature. In their recent report, they examine vessel stiffness in omental resistance vessels obtained from pregnant individuals ≥35 years of age compared to pregnant individuals <35 years of age. Omental arteries were isolated and assessed via pressure myography (mechanical properties) and histological analysis for collagen and elastin content. Overall, the findings from this investigation report that maternal resistance arteries collected from women of advanced maternal age were less compliant and had less elastin than arteries obtained from women <35 years of age, suggesting that maternal resistance vessel stiffening in advanced maternal age may contribute to increased risk of adverse pregnancy outcomes. The authors should be commended for completing these studies in human resistance vessels, which now open new avenues for investigation and provoke a cascade of questions related to maternal cardiovascular adaptations to pregnancy in women ≥35 years of age.

show abstract

Advanced Maternal Age Impairs Uterine Artery Adaptations to Pregnancy in Rats

Cited by 11 publications

References 68 publications

Increased stiffness of omental arteries from late pregnant women at advanced maternal age

Increased stiffness of omental arteries from late pregnant women at advanced maternal age

Dose-response associations of maternal age with pregnancy complications and multimorbidity among nulliparas and multiparas: A multicentric retrospective cohort study in southern China

Commentary on: Increased stiffness of omental arteries from late pregnant women at advanced maternal age

Contact Info

Product

Resources

About