Mechanisms linking exposure to preeclampsia <i>in utero</i> and the risk for cardiovascular disease

Gatford, Kathryn L.; Care, Alison S.; Bianco‐Miotto, Tina; Lassi, Zohra S; Dekker, Gus; Arstall, Margaret; Roberts, Claire T.

doi:10.1017/s2040174420000094

Cited by 24 publications

(38 citation statements)

References 96 publications

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“…This concept that early physiological challenges can alter the developmental trajectories and disease risk of progeny is referred to as developmental programming. Interestingly, many of the pregnancy complications associated with shift work are also associated with metabolic, cardiovascular and endocrine disease in progeny (Godfrey & Barker, 2000;Parkinson et al 2013;Knop et al 2018;Andraweera et al 2020). However very little is known about the direct impact of maternal shift work on progeny health.…”

Section: Introductionmentioning

confidence: 99%

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Simulated shift work during pregnancy does not impair progeny metabolic outcomes in sheep

Gatford

Kennaway

Liu

et al. 2020

The Journal of Physiology

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Key points Maternal shift work increases the risk of pregnancy complications, although its effects on progeny health after birth are not clear. We evaluated the impact of a simulated shift work protocol for one‐third, two‐thirds or all of pregnancy on the metabolic health of sheep progeny. Simulated shift work had no effect on growth, body size, body composition or glucose tolerance in pre‐pubertal or young adult progeny. Glucose‐stimulated insulin secretion was reduced in adult female progeny and insulin sensitivity was increased in adult female singleton progeny. The results of the present study do not support the hypothesis that maternal shift work exposure impairs metabolic health of progeny in altricial species. Abstract Disrupted maternal circadian rhythms, such as those experienced during shift work, are associated with impaired progeny metabolism in rodents. The effects of disrupted maternal circadian rhythms on progeny metabolism have not been assessed in altricial, non‐litter bearing species. We therefore assessed postnatal growth from birth to adulthood, as well as body composition, glucose tolerance, insulin secretion and insulin sensitivity, in pre‐pubertal and young adult progeny of sheep exposed to control conditions (CON: 10 males, 10 females) or to a simulated shift work (SSW) protocol for the first one‐third (SSW0‐7: 11 males, 9 females), the first two‐thirds (SSW0‐14: 8 males, 11 females) or all (SSW0‐21: 8 males, 13 females) of pregnancy. Progeny growth did not differ between maternal treatments. In pre‐pubertal progeny (12–14 weeks of age), adiposity, glucose tolerance and insulin secretion during an i.v. glucose tolerance test and insulin sensitivity did not differ between maternal treatments. Similarly, in young adult progeny (12–14 months of age), food intake, adiposity and glucose tolerance did not differ between maternal treatments. At this age, however, insulin secretion in response to a glucose bolus was 30% lower in female progeny in the combined SSW groups compared to control females (P = 0.031), and insulin sensitivity of SSW0‐21 singleton females was 236% compared to that of CON singleton female progeny (P = 0.025). At least in this model, maternal SSW does not impair progeny metabolic health, with some evidence of greater insulin action in female young adult progeny.

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Section: Introductionmentioning

confidence: 99%

“…2018; Andraweera et al . 2020). However very little is known about the direct impact of maternal shift work on progeny health.…”

Section: Introductionmentioning

confidence: 99%

Simulated shift work during pregnancy does not impair progeny metabolic outcomes in sheep

Gatford

Kennaway

Liu

et al. 2020

The Journal of Physiology

Self Cite

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“…4 PE is marked by abnormal placentation of the spiral arteries whereby the ischemic placenta, resultant hypoxia in the fetus, and endothelial dysfunction may lead to alterations in the morphology and function of the heart and the major vessels of the developing fetus. 5,6 In vivo studies have suggested the role of hypoxia in epicardial detachment and cardiac collagen content that may lead to alterations in cardiac shape of offspring. 5 The excess of antiangiogenic factors in utero that are triggered by placental dysfunction may possibly lead to vascular remodeling.…”

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confidence: 99%

Cardiovascular Dysfunction in Children Exposed to Preeclampsia During Fetal Life

Hoodbhoy

Mohammed

Rozi

et al. 2021

Journal of the American Society of Echocardiography

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Background: Keeping in view the developmental origin of health and disease hypothesis, the aim of this study was to assess differences in cardiac and vascular structure and function in children exposed to preeclampsia in utero compared with those of normotensive mothers. The hypothesis under investigation was that children exposed to preeclampsia would have altered cardiac and vascular structure and function compared with the unexposed group.Methods: This was a retrospective cohort study that included children 2 to 10 years of age born to mothers with and without exposure to preeclampsia in utero (n = 80 in each group). Myocardial morphology and function using echocardiography and carotid intima-media thickness and pulse-wave velocity were determined. Multivariate linear regression was used to compare preeclampsia-exposed and nonexposed groups. Subgroup analysis to assess differences between early-and late-onset preeclampsia was also performed.Results: Forty-one percent of mothers (n = 33) had early-onset preeclampsia. Children in the exposed group had a significantly higher prevalence of stage 1 systolic and diastolic hypertension (22% [n = 18] and 35% [n = 18], respectively) compared with the unexposed group (9% [n = 7] and 19% [n = 15], respectively; P = .01). Children in the exposed group also had higher pulse-wave velocity compared with those in the unexposed group (0.42 6 0.1 vs 0.39 6 0.1, P = .03). Subgroup analysis revealed that changes in blood pressure and pulse-wave velocity were determined primarily by early-onset preeclampsia. There was no significant difference in cardiac morphology or systolic and diastolic function between the exposed and unexposed groups. Conclusion:In utero exposure to preeclampsia has an effect on vascular function in children aged 2 to 10 years, related primarily to early-onset disease. Routine blood pressure screening should be recommended for such children.

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“…Besides the immediate risk preeclampsia poses to the pregnancy, the mother and the fetus, offspring prenatally exposed to preeclampsia may be at risk for long term adverse health effects [3][4][5]. Women with a history of preeclampsia are at increased risk for long-term morbidities, including chronic hypertension, diabetes and atherosclerotic morbidity such as cardiovascular and renal disease, besides preeclampsia in future pregnancies [6][7][8].…”

Section: Introductionmentioning

confidence: 99%

Who Is at Risk for Preeclampsia? Risk Factors for Developing Initial Preeclampsia in a Subsequent Pregnancy

Wainstock

Sergienko

2020

JCM

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Background: The incidence of preeclampsia, which may cause significant maternal and perinatal morbidity, has risen in recent years, therefore it is critical to identify women at risk for preeclampsia. We aimed to identify risk factors in the first pregnancy (not complicated by preeclampsia) for preeclampsia in the subsequent pregnancy. Methods: A retrospective population-based nested case-control study was conducted, including all women with first (P1) and second (P2) singleton consecutive deliveries. Women who had experienced preeclampsia in their first pregnancy were excluded. Cases were defined as women with preeclampsia in their second pregnancy, and were compared to the controls, defined as women without this diagnosis in second pregnancy. Characteristics and complications of the first pregnancy were compared between cases and controls, and multivariable regression models were used to study the association between pregnancy complications (in the first pregnancy) and preeclampsia (in the subsequent pregnancy), while adjusting for confounders. Results: A total of 40,673 women were included in the study, 1.5% of second pregnancies were diagnosed with preeclampsia (n = 627, i.e., Cases). Cases, as compared to controls were older in their 1st pregnancy, with longer inter-pregnancy interval, and were more likely to have the following complications in their first pregnancy: preterm delivery (15.0% vs. 7.7%), low birthweight (17.9% vs. 10.3%), perinatal mortality (3.2% vs. 1.1%), and gestational diabetes (7.0% vs. 2.7%). In the multivariable model, adjusted for maternal age, obesity and inter-pregnancy interval, either one of these first pregnancy complications were independently associated with an increased risk for preeclampsia (adjusted OR for either of first pregnancy complication =1.73; 95% CI 1.37–2.14, <0.001), and the risk was greater for each additional complication (adjusted OR for ≥2 risk factors =3.54; 95% CI 2.28–5.52, p < 0.001). Conclusions: Complications in first pregnancy, including preterm delivery, perinatal mortality and gestational diabetes, are risk factors for primary preeclampsia in second pregnancy. First pregnancy may serve as a window of opportunity to identify women at risk for future preeclampsia and other morbidities later in life.

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Mechanisms linking exposure to preeclampsia in utero and the risk for cardiovascular disease

Cited by 24 publications

References 96 publications

Simulated shift work during pregnancy does not impair progeny metabolic outcomes in sheep

Simulated shift work during pregnancy does not impair progeny metabolic outcomes in sheep

Cardiovascular Dysfunction in Children Exposed to Preeclampsia During Fetal Life

Who Is at Risk for Preeclampsia? Risk Factors for Developing Initial Preeclampsia in a Subsequent Pregnancy

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