Early Life Determinants of Vascular Structure in Fetuses, Infants, Children, and Adolescents: A Systematic Review and Meta-Analysis

Varley, Benjamin J; Nasir, Reeja; Skilton, Michael R.; Craig, Maria E.; Gow, Megan L.

doi:10.1016/j.jpeds.2022.08.033

Cited by 7 publications

(5 citation statements)

References 69 publications

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“…However, future studies which include a mix of exposure to early and late onset may be helpful in determining the impact of intrauterine preeclampsia exposure on vascular health. We followed best practice procedures for data collection ( 6 , 47 ), using validated and acceptable methods for assessing early arterial injury in children ( 42 , 48 , 49 ), which contrasts other published studies ( 20 , 32 ). Other adverse complications such as low birth weight and preterm birth increase CVD risk in later life ( 45 , 46 ), however, we found no associations between aIMT or PWV and confounders in univariate or sub-group analysis.…”

Section: Discussionmentioning

confidence: 99%

“…However, abdominal aorta intima-media thickness (aIMT) may be a more appropriate measure in children ( 6 , 12 , 13 ), as it is more sensitive to childhood risk factors including familial hypercholesterolemia, type 1 diabetes ( 13 ), and adverse outcomes during pregnancy such as fetal growth restriction ( 14 , 15 ) and large for gestational age ( 16 , 17 ). Preliminary evidence has shown greater aIMT in neonates exposed to preeclampsia compared to those unexposed ( 18 – 20 ), whereas effects on PWV during childhood are conflicting ( 21 , 22 ).…”

Section: Introductionmentioning

confidence: 99%

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Intrauterine exposure to preeclampsia does not impair vascular health in children

Varley

Henry²,

Roberts³

et al. 2022

Front. Public Health

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Background and objectivesPreeclampsia is a serious multisystem blood pressure disorder during pregnancy that is associated with increased long-term risk of cardiovascular disease to the mother and offspring. We investigated the vascular health of children exposed to intrauterine preeclampsia.Materials and methodsThis was a cross-sectional study of offspring in a prospective cohort of women with complications during pregnancy. Children aged between 2 and 5 years [median age 4.7 (2.8, 5.1) years] exposed to intrauterine preeclampsia (n = 26) or normotensive controls (n = 34), were recruited between July 2020 and April 2021. Vascular health was assessed by measuring aortic intima-media thickness and pulse wave velocity. Univariate generalized linear regression models were used to explore associations between vascular measurements and explanatory variables.ResultsChildren exposed to preeclampsia had a lower body mass index at assessment (15.5 vs. 16.2 kg/m2, p = 0.04), birth weight (2.90 vs. 3.34 kg, p = 0.004), gestational age at birth (37.5 vs. 39.4 weeks, p < 0.001) and higher frequency of preterm birth (27% vs. 6%, p = 0.02). There were no differences in vascular health between children exposed to preeclampsia vs. controls (mean aortic intima-media thickness 0.575 mm vs. 0.563 mm, p = 0.51, pulse wave velocity 4.09 vs. 4.18 m/s, p = 0.54) and there were no significant associations in univariate analyses.ConclusionsThere were no major adverse differences in vascular health which contrasts with existing studies. This suggests exposure to intrauterine preeclampsia may result in a less severe cardiovascular phenotype in young children. While reassuring, longitudinal studies are required to determine if and when exposure to intrauterine preeclampsia affects vascular health in children.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Intrauterine exposure to preeclampsia does not impair vascular health in children

Varley

Henry²,

Roberts³

et al. 2022

Front. Public Health

Self Cite

View full text Add to dashboard Cite

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“…A recent meta-analysis ( n = 1220 cases, n = 1997 controls), reported the following factors associated with greater aortic intima-media thickness, i.e., atherosclerosis: small for gestational age status, intrauterine growth restriction, and large for gestational age status. 31 …”

Section: Cardiovascular Diseasesmentioning

confidence: 99%

Early-life nutrition and adult-life outcomes

Alves,

Alves

2024

Jornal de Pediatria

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“…A recent systematic review and meta-analysis examined the association between exposures during the first 1000 days of life and aortic intima-media thickness measured from fetuses and children up to 10 years. The study identified that having been born small or large for gestational age, intrauterine growth restriction, preeclampsia, and maternal smoking all associated with greater aortic intima-media thickness in neonates 7 .…”

Section: Introductionmentioning

confidence: 99%

Maternal prenatal psychological distress is associated with aortic intima-media thickness in infants in the FinnBrain Birth Cohort Study

Aatsinki,

Snäll,

Pahkala

et al. 2024

Preprint

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AimsThe origins of cardiovascular health are embedded in early life. It has been suggested that exposure to prenatal stress is linked with markers of cardiovascular structure and functioning. We aimed to explore in the FinnBrain Birth Cohort Study if and how maternal prenatal psychological distress – a potentially modifiable risk factor – associates with infant aortic intima-media thickness (aIMT).MethodsMaternal symptoms were measured 2-3 times during pregnancy using EPDS for depressive symptoms, SCL-90 anxiety subscale for general anxiety and PRAQ-R2 for pregnancy-specific anxiety. Vascular ultrasonography was performed at the age of 2-3 months (n=273) and aIMT was measured.ResultsIn adjusted models, mean PRAQ-R2 across pregnancy was positively associated with aIMT. In boys, mean EPDS across pregnancy was associated with a thicker aIMT.ConclusionsOur results indicate that pregnancy-specific anxiety associates with thicker aIMT in both sexes, whereas maternal depressive symptoms associate with thicker aIMT in boys only.Lay SummaryStress during pregnancy changes maternal physiology, and is related with child development. We studied how mother’s tress, i.e. symptoms of depression and anxiety, during pregnancy links with cardiovascular structure of the infants.Mothers were asked about their symptoms of depression and anxiety 2-3 times during pregnancy. They were also asked about pregnancy-specific anxiety, meaning worries related to labour, future health of the child and pregnancy-related changes. At the age of 2-3 months, infants were imaged with ultrasound, and the thickness of two innermost layers of the wall of abdominal aorta was measured (aIMT). The thickness may relate with cardiovascular disease risk.pregnancy-related anxiety was linked with thicker aIMT. Additionally, boys showed thicker aIMT when their mothers had depressive symptoms during pregnancy.

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Early Life Determinants of Vascular Structure in Fetuses, Infants, Children, and Adolescents: A Systematic Review and Meta-Analysis

Cited by 7 publications

References 69 publications

Intrauterine exposure to preeclampsia does not impair vascular health in children

Intrauterine exposure to preeclampsia does not impair vascular health in children

Early-life nutrition and adult-life outcomes

Maternal prenatal psychological distress is associated with aortic intima-media thickness in infants in the FinnBrain Birth Cohort Study

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