Effect of Early-Onset Preeclampsia on Offspring's Blood Pressure during the First Month of Life

Chourdakis, Emmanouil; Fouzas, Sotirios; Papadopoulou, Chrissanthy; Oikonomou, Nikos; Hahalis, George; Dimitriou, Gabriel; Karatza, Ageliki

doi:10.1016/j.jpeds.2020.01.033

Cited by 15 publications

(4 citation statements)

References 26 publications

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“…25 On subgroup analysis, children in the early-onset PE subgroup had a higher frequency of stage 1 HTN compared with healthy control subjects. Recent work by Chourdakis et al 26 demonstrated increased BP in neonates exposed to early-onset PE. Higher systolic BP in children aged 6 to 13 years exposed to early-onset PE has also been reported.…”

Section: Discussionmentioning

confidence: 97%

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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Section: Discussionmentioning

confidence: 97%

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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“…These observed cytologic, anatomical, and hemodynamic changes are expressed clinically even in the first month of life. Another study on the offspring of early-onset preeclamptic pregnancies during their first postnatal month showed significantly higher systolic (SBP), diastolic (DBP), and mean blood pressure (MBP) levels among these infants from the second day up to four weeks of life (p < 0.001-0.033), thereby characterizing preeclampsia as a determining factor of alterations in SBP, DBP, and MBP during the first postnatal month (F = 16.2, p < 0.001; F = 16.4, p < 0.001; and F = 17.7, p < 0.001, respectively) [85]. Moreover, the use of echocardiography on the offspring of hypertensive pregnancies at the age of 3 months showed a significantly greater left and right ventricular mass index in addition to a smaller right ventricular ejection fraction [80].…”

Section: Neonatal Age-early Childhoodmentioning

confidence: 98%

Short- and Long-Term Outcomes of Preeclampsia in Offspring: Review of the Literature

et al. 2023

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Preeclampsia is a multisystemic clinical syndrome characterized by the appearance of new-onset hypertension and proteinuria or hypertension and end organ dysfunction even without proteinuria after 20 weeks of pregnancy or postpartum. Residing at the severe end of the spectrum of the hypertensive disorders of pregnancy, preeclampsia occurs in 3 to 8% of pregnancies worldwide and is a major cause of maternal and perinatal morbidity and mortality, accounting for 8–10% of all preterm births. The mechanism whereby preeclampsia increases the risk of the neurodevelopmental, cardiovascular, and metabolic morbidity of the mother’s offspring is not well known, but it is possible that the preeclamptic environment induces epigenetic changes that adversely affect developmental plasticity. These developmental changes are crucial for optimal fetal growth and survival but may lead to an increased risk of chronic morbidity in childhood and even later in life. The aim of this review is to summarize both the short- and long-term effects of preeclampsia on offspring based on the current literature.

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“…21 Cohort studies in humans showed that both gestational HTN and early-onset preeclampsia were associated with the development of HTN in their offspring, especially during the neonatal period, which demonstrates the role of placental insufficiency in the programming of BP. 22 In addition, other causes of fetal stress also result in inadequate fetal growth and correlate to e10 / Arch Argent Pediatr 2022;120(1):e8-e16 / Review a higher prevalence of HTN during adolescence and adulthood. As an example, it is worth noting hypoxia; maternal stress (environmental, emotional, and physiological); microbiota changes; early exposure to glucocorticoids; exposure to toxic substances, such as nicotine and tobacco smoke; alcohol use; and maternal sleep deprivation.…”

Section: Environmental Impact On the Development Of Htnmentioning

confidence: 99%

Early programming of hypertension

Iturzaeta

Tejeira

2022

Arch Argent Pediat

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Hypertension (HTN) is a modifiable risk factor for cardiovascular disease (CVD) and should be included in the study of developmental origins of health and disease (DOHaD). During intrauterine and perinatal development, different environmental factors have an impact on the early programming of noncommunicable diseases (NCDs). This review provides a summary of the evidence that connects the fetus' plasticity and adaptive changes to unfavorable environmental factors that alter the adult phenotype in the development of HTN. Such adaptive changes result from epigenetic changes that favor the development of HTN and CVD in adulthood with intergenerational implications. Lastly, we mention preventive strategies to limit or reverse any variable that may alter developmental programming leading to HTN later in life.

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Effect of Early-Onset Preeclampsia on Offspring's Blood Pressure during the First Month of Life

Cited by 15 publications

References 26 publications

Cardiovascular Dysfunction in Children Exposed to Preeclampsia During Fetal Life

Cardiovascular Dysfunction in Children Exposed to Preeclampsia During Fetal Life

Short- and Long-Term Outcomes of Preeclampsia in Offspring: Review of the Literature

Early programming of hypertension

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