Pulmonary and Systemic Vascular Dysfunction in Young Offspring of Mothers With Preeclampsia

Jayet, Pierre‐Yves; Rimoldi, Stefano F.; Stüber, Thomas; Salmòn, Carlos Salinas; Hutter, Damian; Rexhaj, Emrush; Thalmann, Sébastien; Schwab, Marcos; Turini, Pierre; Sartori-Cucchia, Céline; Nicod, Pascal; Villena, Mercedes; Allemann, Yves; Scherrer, Urs; Sartori, Cláudio

doi:10.1161/circulationaha.110.941203

Cited by 251 publications

(258 citation statements)

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“…5 Recently, it has been found that young offspring of mothers with preeclampsia display marked vascular dysfunction in the systemic circulations and that this endothelial defect in the systemic circulation may contribute to the increased risk of arterial hypertension in the offspring. 22 There could therefore be structural effect of HDP on neonatal blood vessels. 23 Another recent study with similar findings suggests that endothelial dysfunction in the offspring is either persistent after the preeclampsia in pregnancy or there is a heritable predisposition to endothelial dysfunction in both mother and child.…”

Section: Discussionmentioning

confidence: 99%

Does hypertensive disorder of pregnancy predict offspring blood pressure at 21 years? Evidence from a birth cohort study

et al. 2011

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Although few studies found that the offspring of women who experienced preeclampsia have higher blood pressure (BP) at childhood and adolescence, no study has observed whether this association exists for adult offspring. To examine whether maternal hypertensive disorder of pregnancy (HDP) predicts adult offspring BP. We followed a sub-sample of 2608 mother-offspring pairs for 21 years from an original cohort of 7223 singleton infants whose mothers gave birth in Brisbane, Australia between 1981 and 1983. HDP was defined as diastolic BP (DBP) over 90 mm Hg on at least two occasions beyond 20 weeks gestation associated with proteinuria and/or excessive fluid retention. Adult offspring's systolic BP (SBP) and DBP were measured at 21 years. Multivariable regressions were used to examine the independent associations of HDP with offspring BP. Unadjusted regression analysis showed that offspring of women who experienced HDP have 3.46 mm Hg greater SBP and 3.02 mm Hg greater DBP at 21 years. This association remained consistent after adjusting for potential confounding and mediating factors including offspring gender, age, percentile birth weight for gestation, placenta weight and body mass index (BMI) at 21 year, maternal age, education, racial origin, and smoking during pregnancy and their pre-pregnancy BMI. Findings of this study suggest that maternal HDP predicts adult offspring BP. Keywords: hypertensive disorder of pregnancy; offspring blood pressure; young adults IntroductionWomen who develop hypertensive disorder of pregnancy (HDP) or preeclampsia are at an increased risk for high blood pressure (BP) and cardiovascular diseases later in life. 1 Also, men and women born after preeclampsia in pregnancies are likely to trigger severe preeclampsia in their own (or their partner's) pregnancy. 2 Recently, it has been observed that children exposed to preeclampsia are at an increased risk of a variety of diseases including endocrine, nutritional and metabolic diseases. 3 A recent study by Kajantie et al. 4 using the Helsinki Birth Cohort Study found that preeclampsia was associated with increased risk of stroke and severe preeclampsia was associated with hypertension in an adult offspring 60-70 years after their birth. Several other studies also reported that the offspring of women who developed preeclampsia have higher BP in childhood 5-7 and adolescence. [8][9][10][11] A recent meta-analysis also found that offspring of women with preeclampsia had higher levels of BP as compared with offspring from uneventful pregnancies. 12 Most of the studies have reported findings in children and adolescents but not in adults. Some studies have not adjusted for potential confounding or mediating factors such as maternal pre-pregnancy body mass index (BMI) 10 and maternal smoking during pregnancy. 8,11 It is unclear whether the observed associations are spurious or confounded with these factors. Using a long follow-up of a birth cohort study, we have the capacity to examine whether this association between HDP and offspring BP remai...

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Section: Discussionmentioning

confidence: 99%

Does hypertensive disorder of pregnancy predict offspring blood pressure at 21 years? Evidence from a birth cohort study

et al. 2011

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“…[18][19][20] However, because IUGR in human high-risk pregnancy normally occurs as a result of increased placental vascular impedance with consequent falls in oxygen and nutrient delivery to the baby, the relative contributions of chronic hypoxia or of chronic malnutrition during the fetal period in slowing growth and promoting pulmonary vascular anomalies under these con-…”

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“…The feathers in the chest region were carefully plucked and echocardiography was performed (Acuson Siemens, Mountain View, CA) using a pediatric probe 7v3c (3.5-7 MHz), applying standard techniques similar to those described before. 20 Longitudinal and transverse images were obtained at different levels of the heart in the parasternal long-and short-axis using Mmode bi-dimensional (2D) echocardiography. The thickness of the ventricular walls in real time was measured using the have reported that incubation of fertilised eggs from SL hens at HA promoted growth restriction, cardiomegaly, cardiac and aortic wall thickening in the chick embryo, and systemic blood pressure dysregulation in the adult chicken.…”

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confidence: 99%

High-Altitude Hypoxia and Echocardiographic Indices of Pulmonary Hypertension in Male and Female Chickens at Adulthood

Salinas

Blanco

Villena

et al. 2014

Circ J

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Circulation Journal Official Journal of the Japanese Circulation Society http://www. j-circ.or.jp ditions, again, remain uncertain.Experimental studies in animal models, including our own, have used exposure of pregnant mammals to chronic hypobaric or isobaric hypoxia during gestation and have studied the effects on fetal growth and on the cardiovascular system of the offspring in the newborn and adult periods. 21-23 Studies such as these have reported that chronic fetal hypoxia can program persistent pulmonary hypertension in the newborn and pulmonary hypertension in the adult offspring. 24 However, because maternal exposure to hypoxia can lead to a significant decrease in maternal food intake, 25 the extent to which any adverse effects on the pulmonary circulation of the offspring are due to under-nutrition and/or under-oxygenation, once again, remain unclear.The combination of HA exposure with the use of the chick embryo model permits investigation of the direct effects of HA hypoxia on growth and on cardiovascular development completely independent of alterations in placental function, independent of changes in the maternal physiology and independent of any effects of socioeconomic factors. Previously, we ulmonary hypertension continues to be an important clinical problem. 1-8 Studies of populations at high altitude (HA) have unequivocally reported intrauterine growth restriction (IUGR) and a higher prevalence of pulmonary hypertension, 9-17 suggesting that a component of these conditions is associated with exposure to chronic hypoxia. However, because most highland populations are also impoverished, the relative contributions of chronic hypoxia or of chronic malnutrition during the fetal and postnatal periods in stunting growth and promoting pulmonary vascular disease during life at altitude remain uncertain.Similarly, clinical studies at sea level (SL) have reported an association between the IUGR infant and the early development of right ventricular dysfunction and pulmonary hypertension. 18-20 However, because IUGR in human high-risk pregnancy normally occurs as a result of increased placental vascular impedance with consequent falls in oxygen and nutrient delivery to the baby, the relative contributions of chronic hypoxia or of chronic malnutrition during the fetal period in slowing growth and promoting pulmonary vascular anomalies under these con- Background: By combining the chick embryo model with incubation at high altitude (HA), the effects of chronic hypoxia on fetal growth, fetal cardiac and aortic wall remodeling and systemic arterial blood pressure at adulthood were reported. Using non-invasive functional echocardiography, here we investigated the in vivo effects of HA hypoxia on the pulmonary circulation at adulthood in male and female chickens.

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“…Therefore, we evaluated the endothelial function using the FMD jointly to the EndoPAT technology (Fig. 3), only in one study center-Bern University Hospital, Switzerland, with large prior experience with this methodology (28)(29)(30)(31). Description of technical procedure is reported in the Suppl.…”

Section: Accepted M Manuscriptmentioning

confidence: 99%

Rationale and design of the Hunting for the off-target propertIes of Ticagrelor on Endothelial function and other Circulating biomarkers in Humans (HI-TECH) trial

Ariotti

Leeuwen

Brugaletta

et al. 2017

American Heart Journal

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Pulmonary and Systemic Vascular Dysfunction in Young Offspring of Mothers With Preeclampsia

Cited by 251 publications

References 28 publications

Does hypertensive disorder of pregnancy predict offspring blood pressure at 21 years? Evidence from a birth cohort study

Does hypertensive disorder of pregnancy predict offspring blood pressure at 21 years? Evidence from a birth cohort study

High-Altitude Hypoxia and Echocardiographic Indices of Pulmonary Hypertension in Male and Female Chickens at Adulthood

Rationale and design of the Hunting for the off-target propertIes of Ticagrelor on Endothelial function and other Circulating biomarkers in Humans (HI-TECH) trial

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