Endothelial function in children with a history of premature prolonged rupture of membranes and bronchopulmonary dysplasia – a pilot study

Liljedahl, Magnus; Martin, Helena; Magnuson, Anders; Montgomery, Scott; Schollin, Jens

doi:10.1111/j.1651-2227.2008.00802.x

Cited by 3 publications

(2 citation statements)

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“…Preterm birth is nowadays a more common cause of low birthweight than fetal growth restriction in many countries. Although subjects born preterm often grow poorly after birth and face an over‐risk for later hypertension [75,115], diabetes [68,79], and stroke [85], their endothelial function has, with few exceptions [99], been reported to be normal in infancy, childhood, and adolescence, both in the microcirculation [12,13,108,116] and in large arteries [93,108,132]. The reason for the discrepancy in endothelial function between the growth‐retarded fetus and the preterm infant is still unknown.…”

Section: Developmental Origins Of Microvascular Dysfunctionmentioning

confidence: 99%

The Microcirculation: A Target for Developmental Priming

Clough

Norman

2011

Microcirculation

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There is increasing evidence that the early life environment, of which nutrition is a key component, acts through developmental adaptations to set the capacity of cardiovascular and metabolic pathways, and ultimately the limits to physiological challenges in later life. Suboptimal maternal nutrition and fetal growth result in reduced microvascular perfusion and functional dilator capacity, which are strongly associated with later development of obesity, type 2 diabetes, and hypertension. These conditions are also linked to microvascular rarefaction and remodeling that together limit capillary recruitment, reduce exchange capacity and increase diffusion distances of metabolic substrates, and increase local and overall peripheral resistance. Changes in small vessel structure and function may be seen very early, long before the onset of overt cardiovascular and metabolic disease, and may thus be a target for early therapeutic and lifestyle intervention strategies. This article explores how a disadvantageous microvascular phenotype may result from perinatal priming and how developmental plasticity may become an important and additional risk determinant in susceptibility to cardiometabolic disease in adult life.

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Section: Developmental Origins Of Microvascular Dysfunctionmentioning

confidence: 99%

The Microcirculation: A Target for Developmental Priming

Clough

Norman

2011

Microcirculation

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“…Preterm premature rupture of membranes (pPROM) is associated with the increased risk of chorioamnionitis and foetal exposure to inflammation [1]. Available data shows that inflammatory intrauterine environment could have long-term effects including impact on the incidence of respiratory morbidity and cardiovascular system condition through impaired endothelial function [2][3][4][5][6].…”

Section: Introductionmentioning

confidence: 99%

Risk factors associated with neonatal infectious and respiratory morbidity following preterm premature rupture of membranes

et al. 2022

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Objectives: Preterm premature rupture of membranes (pPROM) is associated with the increased risk of chorioamnionitis, foetal exposure to inflammation, and respiratory complications in preterm neonates. The aim of the study was to identify patients at highest risk of developing neonatal infectious and respiratory morbidity following pPROM and preterm birth. Material and methods:It was a retrospective cohort study including 299 consecutive patients in singleton pregnancies complicated by preterm premature rupture of membranes and giving birth between 22 nd and 36 th gestational week. Analysed factors included maternal characteristics, obstetric history, gestational age at pPROM and at delivery, latency and management. Multivariate logistic regression models were applied in order to identify risk factors for severe infectious and respiratory neonatal complications. Results:Earlier gestational age at pPROM is associated with increased probability of developing early-onset neonatal sepsis and pulmonary hypertension. Earlier gestational age at birth and lower birth weight were independent factors associated with neonatal respiratory distress syndrome. Positive cervical culture was identified as a risk factor for acute neonatal respiratory failure.Conclusions: Gestational age at pPROM, gestational age at birth and birth weight were the leading factors influencing the risk of developing neonatal infectious and respiratory morbidity following preterm premature rupture of membranes.

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Developmental Conditioning of the Vasculature

Clough

2014

Comprehensive Physiology

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There is increasing evidence from epidemiological and experimental animal studies that the early life environment, of which nutrition is a key component, acts through developmental adaptive responses to set the capacity of cardiovascular and metabolic pathways to respond to physiological and pathophysiological challenges in later life. One finding that is consistent to both population studies and animal models is the propensity for such effects to induce endothelial dysfunction throughout the vascular tree, including the microvasculature. Obesity, type 2 diabetes and hypertension are associated with changes in microvascular function affecting multiple tissues and organs. These changes may be detected early, often before the onset of macrovascular disease and the development of end organ damage. Suboptimal maternal nutrition and fetal growth result in reduced microvascular perfusion and functional dilator capacity in the offspring, which together with microvascular rarefaction and remodeling serve to limit capillary recruitment, reduce exchange capacity and increase diffusion distances of metabolic substrates; they also increase local and overall peripheral resistance. This article explores how a developmentally conditioned disadvantageous microvascular phenotype may represent an important and additional risk factor for increased susceptibility to the development of cardio-metabolic disease in adult life and considers the cell signaling pathways associated with microvascular dysfunction that may be "primed" by the maternal environment. As the microvasculature has been shown to be a potential target for early therapeutic and lifestyle intervention, this article also considers evidence for the efficacy of such strategies in humans and in animal models of the developmental origins of health and disease.

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Endothelial function in children with a history of premature prolonged rupture of membranes and bronchopulmonary dysplasia – a pilot study

Abstract: A neonatal history of prolonged premature rupture of membranes was associated with later impairment of vascular endothelial function in childhood. This association was not observed with BPD. Some forms of perinatal inflammation may be associated with later cardiovascular function.

Cited by 3 publications

References 41 publications

The Microcirculation: A Target for Developmental Priming

The Microcirculation: A Target for Developmental Priming

Risk factors associated with neonatal infectious and respiratory morbidity following preterm premature rupture of membranes

Developmental Conditioning of the Vasculature

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