Effects of perinatal blood pressure on maternal brain functional connectivity

Kurosaki, Hiromichi; Nakahata, Katsutoshi; Donishi, Tomohiro; Shiro, Michihisa; Ino, Kazuhiko; Tomita, Masaki; Kawamata, Tomoyuki; Kaneoke, Yoshiki

doi:10.1371/journal.pone.0203067

Cited by 5 publications

(5 citation statements)

References 55 publications

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“…In our sample, fathers were significantly more aware and less distressed about typical trial characteristics. We hypothesize that mothers are more emotionally distressed at the moment of consent and often still bear the consequences from medical conditions leading to preterm birth that also affect cognitive functioning and possibly memory [ 27 , 28 ].…”

Section: Discussionmentioning

confidence: 99%

Parental perspectives long term after neonatal clinical trial participation: a survey

Salaets

Lavrysen

Smits

et al. 2020

Trials

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Background Although recruiting newborns is ethically challenging, clinical trials remain essential to improve neonatal care. There is a lack of empirical data on the parental perspectives following participation of their neonate in a clinical trial, especially at long term. The objective of this study is to assess experiences and emotions of parents, long term after trial participation in an interventional drug trial. Methods Parents of former participants of five neonatal interventional drug trials were surveyed at long term (3–13 years ago) after participation. The survey assessed parental contentment with trial participation, perceived influence of the trial on care and health, emotional consequences of participation, and awareness of typical clinical trial characteristics on 6-point Likert scales. Results Complete responses were received from 123 parents (52% of involved families). Twenty percent of parents did not remember participation. Those who remembered participation reported high contentment with overall trial participation (median 5.00), but not with follow-up (median 3.00). Most parents did not perceive any influence of the trial on care (median 2.00) and health (median 2.43). Almost all parents reported satisfaction and pride (median 4.40), while a minority of parents reported anxiety and stress (median 1.44) or guilt (median 1.33) related to trial participation. A relevant minority was unaware of typical trial characteristics (median 4.20; 27% being unaware). Conclusions Overall, parents reported positive experiences and little emotional distress long term after participation. Future efforts to improve the practice of neonatal clinical trials should focus on ensuring effective communication about the concept and characteristics of a clinical trial during consent discussions and on the follow-up after the trial.

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Section: Discussionmentioning

confidence: 99%

Parental perspectives long term after neonatal clinical trial participation: a survey

Salaets

Lavrysen

Smits

et al. 2020

Trials

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“…this study suggest that functional network alterations in formerly pre-eclamptic women are comparable with those seen in hypertensive patients. Additionally, it has been shown that the connectivity in the bilateral orbitofrontal gyri, measured within 10 days after delivery, correlated negatively with the diastolic blood pressure in both cases with PE and controls 36 . This suggests that increased diastolic blood pressure, as present in hypertension, with or without PE, may affect the functional brain network.…”

Section: Discussionmentioning

confidence: 99%

Functional connectivity of limbic system and prefrontal cortex years after pre‐eclampsia: 7‐Tesla functional magnetic resonance imaging study

Canjels

Ghossein‐Doha

Alers

et al. 2022

Ultrasound in Obstet & Gyne

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Objective Pre‐eclampsia is a vascular complication of pregnancy, associated with a long‐term risk of cerebrovascular and mental disorders. We explored whether formerly pre‐eclamptic women exhibit differences in functional brain organization, especially in regions that may explain the commonly reported emotional symptoms and cognitive complaints even years after the pregnancy. Methods Formerly pre‐eclamptic women and control women with a history of normotensive pregnancy underwent structural and functional 7‐Tesla magnetic resonance imaging scans. Using graph theoretical analysis, the efficiency and clustering coefficient of the functional brain network were investigated. The study included local analysis focusing on particular brain structures, such as the limbic system and the prefrontal cortex, and global analysis of the whole cerebrum. Univariable and multivariable linear regression was used to investigate the relationship between brain network‐related graph measures and the group (formerly pre‐eclamptic or control). Results A total of 17 control parous women and 55 women with a history of pre‐eclampsia were recruited. The time intervals between the index pregnancy and recruitment were 8.0 and 5.6 years for the two groups, respectively. Compared with control women, formerly pre‐eclamptic women had higher local efficiency in the prefrontal cortex (P = 0.048) and anterior cingulate cortex (P = 0.03) but lower local efficiency and local clustering coefficient in the amygdala (P = 0.004 and P = 0.02, respectively) and parahippocampal cortex (P = 0.007 and P = 0.008, respectively). No differences were found in the global functional brain organization. Conclusions Compared to controls with a history of normotensive pregnancy, formerly pre‐eclamptic women displayed a different local functional brain organization. These differences in functional connectivity, especially in the limbic regions and the prefrontal cortex, are in line with the psychological and cognitive complaints reported commonly by women with a history of pre‐eclampsia. © 2022 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.

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“… Uric acid and lactate dehydrogenase levels are one of the indicators reflecting the severity of endothelial dysfunction, which have a high correlation with RPLS. This study found that both significantly increased in the RPLS group, suggesting that endothelial inflammatory injury might play an important role in the process of brain edema of RPLS, which could be used as a predictor of the degree of brain edema of RPLS [ 22 – 24 ]. This study found that the ALT level in the RPLS group was higher than that in the non-RPLS group, and the AST and ALT levels in the two groups were significantly higher than the normal value, indicating varying degrees of damage to the liver function of pregnant women with pregnancy-induced hypertension or SPE/E combined with RPLS, but this was not a specific index [ 24 ].…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Clinical and Imaging Data-Based Model for Predicting Reversible Posterior Leukoencephalopathy Syndrome (RPLS) in Pregnant Women With Severe Preeclampsia or Eclampsia and Analysis of Perinatal Outcomes

Zhang

et al. 2022

International Journal of Clinical Practice

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Objective. This study aimed to investigate the risk factors of reversible posterior leukoencephalopathy syndrome (RPLS) in pregnant women with severe preeclampsia or eclampsia (SPE/E) based on a predicting model and to analyze the perinatal outcomes. Methods. From January 2015 to March 2020, 78 pregnant women data diagnosed with severe preeclampsia or eclampsia with cranial magnetic resonance imaging (MRI) and transcranial Doppler (TCD) screening in Xiangyang No. 1 People’s Hospital and Jiangsu Province Hospital of Chinese Medicine were analyzed retrospectively. They were divided into the RPLS group (n = 33) and non-RPLS group (n = 45) based on the MRI results. The general clinical data (blood pressure, BMI, symptoms, and so forth), laboratory examination, TCD results, and perinatal outcomes in the two groups were compared. The risk factors of severe preeclampsia or eclampsia complicated with RPLS were analyzed by multivariate logistic regression. The prediction model and decision curve (DCA) were established according to the clinical-imaging data. Results. The univariate analysis showed that poor placental perfusion, hypertension emergency, use of two or more oral antihypertensive drugs, headache, white blood cell (WBC) count, platelet (PLT) count, lactate dehydrogenase (LDH), alanine aminotransferase (ALT), uric acid (UA), serum albumin (ALB), average flow velocity, and resistance index of the posterior cerebral and basilar arteries were significantly different in the RPLS group compared with the non-RPLS group (all P < 0.05 ). The multivariate logistic regression analysis showed that hypertensive emergency, headache, WBC, PLT, ALT, and average flow velocity of the basilar artery (BAAFV) were the risk factors in the RPLS group. The aforementioned clinical-imaging data modeling (general data model, laboratory examination model, TCD model, and combined model) showed that the combined model predicted RPLS better. DCA also confirmed that the net benefit of the combined model was higher. In addition, the incidence of postpartum hemorrhage, stillbirth, and preterm infants was higher in the RPLS group than in the non-RPLS group (all P < 0.05 ). Conclusions. More postpartum complications were detected in pregnant women with severe preeclampsia or eclampsia complicated with RPLS. Hypertensive emergency, headache, WBC, PLT, ALT, and BAAFV were the important risk factors for RPLS. The combined model had a better effect in predicting RPLS.

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Effects of perinatal blood pressure on maternal brain functional connectivity

Cited by 5 publications

References 55 publications

Parental perspectives long term after neonatal clinical trial participation: a survey

Parental perspectives long term after neonatal clinical trial participation: a survey

Functional connectivity of limbic system and prefrontal cortex years after pre‐eclampsia: 7‐Tesla functional magnetic resonance imaging study

Clinical and Imaging Data-Based Model for Predicting Reversible Posterior Leukoencephalopathy Syndrome (RPLS) in Pregnant Women With Severe Preeclampsia or Eclampsia and Analysis of Perinatal Outcomes

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