Developmental Origins and Nephron Endowment in Hypertension

Gurusinghe, Shari; Tambay, Anita V.; Sethna, Christine B.

doi:10.3389/fped.2017.00151

Cited by 35 publications

(26 citation statements)

References 83 publications

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“…51–54 The developing kidney may be particularly susceptible to these effects, as all nephrons are formed in utero beginning around gestational week 4, 55 and a deficit in nephrons at birth has been associated with a higher risk for hypertension later in life. 56 In support of this, there is evidence that Pb may be nephrotoxic 57, 58 and that in utero Pb exposure adversely affects kidney function and increases blood pressure later in life. 59 However, additional studies will be needed to investigate whether impaired kidney development may mediate the observed associations between prenatal Pb exposure and child SBP.…”

Section: Discussionmentioning

confidence: 97%

Prenatal lead exposure and elevated blood pressure in children

Farzan

Howe

Chen

et al. 2018

Environment International

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Growing evidence suggests that environmental exposures can influence blood pressure over the course of a lifetime. Exposure to toxic metals, such as lead (Pb) and arsenic (As), has been associated with increased blood pressure in adults, but few studies have examined the impacts of in utero and early life toxic metals exposure on blood pressure in childhood. As subclinical vascular changes are thought to begin early in life, it is possible that in utero toxic metals exposure may play a role in blood pressure homeostasis. In the ongoing New Hampshire Birth Cohort Study, we investigated whether in utero exposure to Pb and As was associated with measures of blood pressure in a total of 323 young children (mean age 5.5 years, SD 0.4). Pb and As were measured in maternal toenail samples collected at ~28 weeks gestation (n= 257) and/or 6 weeks postpartum (n = 285), which represent exposures ~6 to 12 months prior to collection and therefore reflect the early prenatal and late prenatal exposures, respectively. Five measurements of systolic blood pressure (SBP) and diastolic blood pressure (DBP) were averaged for each child using a standardized technique. In linear regression analyses, where log2-transformed prenatal toenail Pb and As were modeled jointly and adjusted for child age, sex, height, weight and maternal smoking during pregnancy, we observed that a doubling of maternal prenatal toenail Pb was associated with statistically significant increases in child SBP (β: 0.58 mmHg, 95% CI: 0.05, 1.11). We did not observe any association of prenatal or postpartum As, or postpartum Pb, with SBP or DBP. Exploratory sex-stratified analyses suggest that associations of prenatal Pb with BP may be stronger among boys (SBP β: 0.72 mmHg: 95% CI: −0.01, 1.44; DBP β: 0.37; 95% CI: −0.09, 0.84), compared to girls (SBP β: 0.48 mmHg: 95% CI: −0.31, 1.26; DBP β: −0.05; 95% CI: −0.52, 0.41), though tests for interaction did not reach statistical significance (p-interaction SBP = 0.059; DBP = 0.057). Our preliminary results suggest that in utero toxic metals exposures may be associated with early life increases in blood pressure in children, which could have consequences for long-term health.

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Section: Discussionmentioning

confidence: 97%

Prenatal lead exposure and elevated blood pressure in children

Farzan

Howe

Chen

et al. 2018

Environment International

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“…Accumulating epidemiological and experimental evidence indicate that the impacts of suboptimal conditions during intrauterine life might be far‐reaching, as data suggest that growth and developmental delays in utero influence the risk for different diseases later (e.g., hypertension and diabetes) in adulthood, which are of great public health concern (McMillen and Robinson, ; Kanaka‐Gantenbein, ; Gurusinghe et al, ).…”

Section: Hypoxia and Fetal Programming Of Healthmentioning

confidence: 99%

Hypoxia: From Placental Development to Fetal Programming

Fajersztajn

Veras

2017

Birth Defects Research

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Hypoxia may influence normal and different pathological processes. Low oxygenation activates a variety of responses, many of them regulated by hypoxia-inducible factor 1 complex, which is mostly involved in cellular control of O consumption and delivery, inhibition of growth and development, and promotion of anaerobic metabolism. Hypoxia plays a significant physiological role in fetal development; it is involved in different embryonic processes, for example, placentation, angiogenesis, and hematopoiesis. More recently, fetal hypoxia has been associated directly or indirectly with fetal programming of heart, brain, and kidney function and metabolism in adulthood. In this review, the role of hypoxia in fetal development, placentation, and fetal programming is summarized. Hypoxia is a basic mechanism involved in different pregnancy disorders and fetal health developmental complications. Although there are scientific data showing that hypoxia mediates changes in the growth trajectory of the fetus, modulates gene expression by epigenetic mechanisms, and determines the health status later in adulthood, more mechanistic studies are needed. Furthermore, if we consider that intrauterine hypoxia is not a rare event, and can be a consequence of unavoidable exposures to air pollution, nutritional deficiencies, obesity, and other very common conditions (drug addiction and stress), the health of future generations may be damaged and the incidence of some diseases will markedly increase as a consequence of disturbed fetal programming. Birth Defects Research 109:1377-1385, 2017.© 2017 Wiley Periodicals, Inc.

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“…15,16 Hughson et al 15 found that for each extra 1 kg in birth weight, there was an increase of 257,426 glomeruli. This association is particularly important because a decreased number of glomeruli is associated with more elevated BP levels, 17,18 which is consonant with the Theory of Nephrons, a theory that seeks to explain the relationship between prematurity and SAH in adult life. This might also be related to the increased prevalence of SAH in our cohort.…”

Section: Discussionmentioning

confidence: 81%

Systemic Arterial Hypertension in Childhood: A Challenge Related to the Increasing Survival of Very Low Birth Weight Preterm Infants

et al. 2018

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Objective To verify the prevalence of systemic arterial hypertension (SAH) and to identify possible early predictors of SAH at ages 2 and 4 years in very low birth weight (VLBW) infants. Study Design This is a prospective cohort study including inborn children with birth weight (BW) <1,500 g. Arterial blood pressure measurements were performed at 2 and 4 years. Model 1 compared children with and those without SAH at age 4. Model 2 compared children who had SAH at ages 2 and 4 with the others. SAH was diagnosed if the systolic or/and diastolic pressures were above the 95th percentile. Results A total of 198 patients were included during the 5-year study period, of whom 56% had SAH at age 4. In model 1, white matter injury (WMI) and catch-up growth at age 2 were predictors of SAH at age 4. In model 2, bronchopulmonary dysplasia, WMI, catch-up growth at age 2, and BW were predictors of SAH at 2 and 4 years. SAH at age 2 was an independent risk factor for SAH at age 4. After a multivariate analysis of model 2, BW and catch-up growth were associated with SAH. Conclusion Prevalence of SAH was high in VLBW infants; it was associated with low BW and catch-up growth at age 2.

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Developmental Origins and Nephron Endowment in Hypertension

Cited by 35 publications

References 83 publications

Prenatal lead exposure and elevated blood pressure in children

Prenatal lead exposure and elevated blood pressure in children

Hypoxia: From Placental Development to Fetal Programming

Systemic Arterial Hypertension in Childhood: A Challenge Related to the Increasing Survival of Very Low Birth Weight Preterm Infants

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