Cardiovascular Risk Factors in Children and Young Adults Born to Preeclamptic Pregnancies: A Systematic Review

Davis, Esther; Lazdam, Merzaka; Lewandowski, Adam J.; Worton, Stephanie; Kelly, Brenda; Kenworthy, Yvonne; Adwani, Satish; Wilkinson, A; McCormick, Kenny; Sargent, Ian L.; Redman, Christopher W.G.; Leeson, Paul

doi:10.1542/peds.2011-3093

Cited by 426 publications

(374 citation statements)

References 56 publications

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“…A pregnancy complicated by preeclampsia identifies both mother and child with an unusual predisposition to develop cardio vascular diseases. 2,3 Cardiac failure with pulmonary edema may occur in hypertensive patients with normal heart. Preeclampsia is a recognised predisposing factor for peripartum cardiomyopathy and future cardiovascular disease.…”

mentioning

confidence: 99%

Left ventricular dysfunction in preeclampsia: an echocardiographic study

Sengodan

Dhanapal

Pandian

2017

Int J Reprod Contracept Obstet Gynecol

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INTRODUCTIONPreeclampsia is an acute increase in blood pressure during the second half of pregnancy which is short-lived. More than 50% of the women with elevated blood pressure during pregnancy return to normal by 6-12 weeks postpartum. In developing countries preeclampsia ranks second to anaemia as a cause of maternal morbidity and mortality complicating 7-10% of all pregnancies.Preeclampsia is associated with both immediate and long term postpartum morbidity and mortality due to cardiac related issues.1 The pathological changes in this disorder are primarily ischemic in nature and are known to affect the placenta, kidney, liver and brain whereas there is scant and conflicting information about the impact on heart. Preeclampsia causes left ventricle dysfunction and myocardial injury. Significant proportion of preeclamptic patients show cardiopulmonary morbidity and autopsy ABSTRACT Background: Preeclampsia is a pregnancy specific disorder which constitutes hypertension and proteinuria after 20 weeks of gestation. It is a multisystem disorder of unknown etiology. Preeclampsia is associated with significantly higher prevalence of asymptomatic global left ventricular function and myocardial injury than uneventful pregnancy. This study was undertaken to evaluate the Left ventricular changes in preeclamptic women and to compare with normotensive women. Methods: This prospective study on left ventricular systolic and diastolic function by echocardiography was undertaken in normal and preeclamptic pregnant women who got admitted during the period of one year from January 2015 to December 2015 at Government Mohan Kumaramangalam Medical College and Hospital, Salem. Study population was divided into two groups. GROUP 1-Preeclamptic pregnant women GROUP 2-Normotensive pregnant women as control. Results: There were significant differences in the mean end diastolic dimensions when compared to systolic dimension between two groups. Conclusions: Women with preeclampsia have significant systolic and diastolic dysfunction compared to normotensive pregnant women. Effective management of patients who showed left ventricular dysfunction prevented pulmonaryedema and cardiac failure. This study emphasizes the importance of identifying this subset of preeclamptic patients with ECHO changes who are at higher risk of developing cardiovascular complications later in life by undergoing echocardiography.

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mentioning

confidence: 99%

Left ventricular dysfunction in preeclampsia: an echocardiographic study

Sengodan

Dhanapal

Pandian

2017

Int J Reprod Contracept Obstet Gynecol

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“…10 Furthermore, women who experience a PE pregnancy with aberrant angiogenic factor expression will continue to exhibit an increased lifetime risk for cardiovascular disease. 11,12 The lifetime risk outcomes are also suboptimal for the offspring of pre-eclamptic pregnancies (PE-F1s), who display an elevated risk of cardiovascular disease and stroke 13,14 as well as impaired cognitive function 15,16 and increased depressive signs.…”

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confidence: 99%

Brain Structural and Vascular Anatomy Is Altered in Offspring of Pre-Eclamptic Pregnancies: A Pilot Study

Rätsep¹,

Paolozza

Hickman³

et al. 2015

American Journal of Neuroradiology

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BACKGROUND AND PURPOSE:Pre-eclampsia is a serious clinical gestational disorder occurring in 3%-5% of all human pregnancies and characterized by endothelial dysfunction and vascular complications. Offspring born of pre-eclamptic pregnancies are reported to exhibit deficits in cognitive function, higher incidence of depression, and increased susceptibility to stroke. However, no brain imaging reports exist on these offspring. We aimed to assess brain structural and vascular anatomy in 7-to 10-year-old offspring of pre-eclamptic pregnancies compared with matched controls.

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“…Supportive of protective pleiotropic effects on preeclampsia and cardiovascular risk factors, we found the A allele of the LCT SNP to be nominally associated with decreased glucose levels in the adolescents. To date, there is limited evidence of the association between exposure to preeclampsia in utero and the offspring's fasting glucose metabolism later in life [5,6]. The LCT SNP was out of Hardy-Weinberg equilibrium for mothers, the same observation made by Johnson et al in their Australian preeclampsia case-control cohort [19].…”

Section: Discussionmentioning

confidence: 67%

“…A large review and metaanalysis found that women with a history of preeclampsia have approximately four-fold increased risk of chronic hypertension, and two-fold increased risk of coronary artery disease and stroke 10-15 years after pregnancy [1]. The offspring of women with preeclampsia have higher mean systolic and diastolic blood pressure in childhood and early adult life in both genders, including those with normal birth weight [4][5][6]. Furthermore, they have almost a two-fold greater risk of stroke in adulthood [3].…”

Section: Introductionmentioning

confidence: 99%

Preeclampsia and cardiovascular disease share genetic risk factors on chromosome 2q22

Løset

Johnson

Melton

et al. 2014

Pregnancy Hypertension: An International Journal of Women's Car

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Objective: Four putative single nucleotide polymorphism (SNP) risk variants at the preeclampsia susceptibility locus on chromosome 2q22; rs2322659 (LCT), rs35821928 (LRP1B), rs115015150 (RND3) and rs17783344 (GCA), were recently shown to associate with known cardiovascular risk factors in a Mexican American cohort. This study aimed to further evaluate the pleiotropic effects of these preeclampsia risk variants in an independent Australian population-based cohort. Methods:The four SNPs were genotyped in the Western Australian Pregnancy Cohort (Raine) Study that included DNA, clinical and biochemical data from 1,246 mothers and 1,404 of their now adolescent offspring. Genotype association analyses were undertaken using the SOLAR software.Results: Nominal associations (P < 0.05) with cardiovascular risk factors were detected for all four SNPs. The LCT SNP was associated with decreased maternal height (P = 0.005) and decreased blood glucose levels in adolescents (P = 0.022). The LRP1B SNP was associated with increased maternal height (P = 0.026) and decreased maternal weight (P = 0.044). The RND3 SNP was associated with decreased triglycerides in adolescents (P = 0.001). The GCA SNP was associated with lower risk in adolescents to be born of a preeclamptic pregnancy (P = 0.003) and having a mother with prior preeclamptic pregnancy (P = 0.033). Conclusions:Our collective findings support the hypothesis that genetic mechanisms for preeclampsia and CVD are, at least in part, shared, but need to be interpreted with some caution as a Bonferroni correction for multiple testing adjusted the statistical significance threshold (adjusted P < 0.001).

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Cardiovascular Risk Factors in Children and Young Adults Born to Preeclamptic Pregnancies: A Systematic Review

Abstract: Young offspring of pregnancies complicated by preeclampsia already have increased blood pressure and BMI, a finding that may need to be considered in future primary prevention strategies for cardiovascular disease.

Cited by 426 publications

References 56 publications

Left ventricular dysfunction in preeclampsia: an echocardiographic study

Left ventricular dysfunction in preeclampsia: an echocardiographic study

Brain Structural and Vascular Anatomy Is Altered in Offspring of Pre-Eclamptic Pregnancies: A Pilot Study

Preeclampsia and cardiovascular disease share genetic risk factors on chromosome 2q22

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