Hypertensive disorders during pregnancy and elevated blood pressure in the offspring

Yu, Huiyang; He, Yuan; Mao, Zhengxia; Dong, Wenbing; Fu, Xiaodong; Lei, Xiaoping

doi:10.1097/md.0000000000015677

Cited by 9 publications

(7 citation statements)

References 39 publications

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“…This meta‐analysis was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) guidelines (Table S1), 13 and the supporting data can be found at the PROSPERO website (https://www.crd.york.ac.uk/prospero/) with registration number CRD 42018110872. The detailed protocol has been previously published, 14 and approval was not required because the data are anonymous in peer‐reviewed review papers. We performed a detailed search strategy in PubMed, Embase, Web of Science, and Cochrane library from database inception to January 2022 (sText).…”

Section: Methodsmentioning

confidence: 99%

Association between hypertensive disorders during pregnancy and elevated blood pressure in offspring: A systematic review and meta‐analysis

Mao

et al. 2022

J of Clinical Hypertension

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Hypertensive disorders during pregnancy (HDP) are associated with cardiovascular disease among mothers and offspring. This meta-analysis was conducted to further explore the associations between maternal HDP and offspring blood pressure (BP). The authors performed a search strategy in PubMed, Embase, Web of Science, and Cochrane library from database inception to January 2022. Twenty-four studies regarding HDP were included, with pregnancy-associated hypertension (PAH), preeclampsia (PE), gestational hypertension (GH), and chronic hypertension included in 12, 16, 6, and 3 studies, respectively. Offspring who were exposed to HDP and PAH

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Section: Methodsmentioning

confidence: 99%

Association between hypertensive disorders during pregnancy and elevated blood pressure in offspring: A systematic review and meta‐analysis

Mao

et al. 2022

J of Clinical Hypertension

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“…Studies have pointed to the high risk of adverse outcomes in pregnant women who have overlapping pathologies [3][4][5]. It was not possible in this study to consider the subtypes diagnosed in the different groups under a more detailed analysis, as the choice was made not to stratify the samples for an individualized analysis of the cases.…”

Section: Plos Onementioning

confidence: 99%

“…Hypertensive disorders of pregnancy appear as a hypertensive condition that develops at any time after 20 weeks of pregnancy, accompanied or not by proteinuria. Among the manifestations of these syndromes is eclampsia, which presents with a convulsive component, and HELPP syndrome, which manifests with the presence of hemolysis, elevated liver enzymes and thrombocytopenia; HELLP is a severe form of preeclampsia and not a separate disorder [ 3 , 4 ].…”

Section: Introductionmentioning

confidence: 99%

“…The risk factors associated with the development of gestational hypertension, previous history of pre-eclampsia, primiparity, obesity, family history of pre-eclampsia, number of previous pregnancies (if any) and chronic medical conditions, such as hypertension and diabetes, maternal age greater than or equal to 40 years, obesity, diabetes mellitus, chronic kidney disease, systemic lupus erythematosus, presence of antiphospholipid, multiple pregnancies and high altitude. In addition, it is important to highlight the action of transplant of live kidneys, which can increase the risk of developing preeclampsia in the recipients by up to six-fold more than in non-transplanted women [1][2][3][4][5][6].…”

Section: Introductionmentioning

confidence: 99%

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Hypertension induced by pregnancy and neonatal outcome: Results from a retrospective cohort study in preterm under 34 weeks

Moura¹,

Margotto²,

Costa

et al. 2021

PLoS ONE

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Objective The present study seeks to assess the impact of gestational hypertensive disorders on premature newborns below 34 weeks and to establish the main morbidities and mortality in the neonatal period and at 18 months. Materials and methods A retrospective observational study was carried out with 695 premature newborns of gestational age (GA) between 24 and 33 weeks and 6 days, born alive in the Neonatal ICU of Brasília’s Mother and Child Hospital (HMIB), in the period from January 1, 2014, to July 31, 2019. In total, 308 infants were born to hypertensive mothers (G1) and 387 to normotensive mothers (G2). Twin pregnancies and diabetic patients with severe malformations were excluded. Outcomes during hospitalization and outcomes of interest were evaluated: respiratory distress syndrome (RDS), brain ultrasonography, diagnosis of bronchopulmonary dysplasia (BPD), diagnosis of necrotizing enterocolitis, retinopathy of prematurity, breastfeeding rate at discharge, survival at discharge and at 18 months of chronological age and relationship between weight and gestational age. Results Newborns with hypertensive mothers had significantly lower measurements of birth weight and head circumference. The G1 group had a higher risk small for gestational age (OR 2.4; CI 95% 1.6–3.6; p <0.00), as well as a greater risk of being born with a weight less than 850 g (OR 2.4; 95% CI 1.2–3.5; p <0.00). Newborns of mothers with hypertension presented more necrotizing enterocolitis (OR 2.0; CI 95% 1.1–3.7); however, resuscitation in the delivery room and the need to use surfactant did not differ between groups, nor did the length of stay on mechanical ventilation, or dependence on oxygen at 36 weeks of gestational age. Survival was better in newborns of normotensive mothers, and this was a protective factor against death (OR 0.7; 95% CI 0.5–0.9; p <0.01). In the follow-up clinic, survival at 18 months of chronological age was similar between groups, with rates of 95.3% and 92.1% among hypertensive and normotensive mothers, respectively. Exclusive breastfeeding at discharge was 73.4% in the group of hypertensive women and 77.3% in the group of normotensive mothers. There were no significant differences between groups. Conclusion Among the analyzed outcomes, arterial hypertension during pregnancy can increase the risk of low weight, small babies for gestational age (SGA), deaths in the neonatal period and enterocolitis, with no differences in weight and survival at 18 months of chronological age. Arterial hypertension presents a high risk of prematurity in the neonatal period, with no difference at 18 months of age.

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“…A new, systematic review and meta-analysis on the subject is being carried out. So far, only the protocol of this study has been published; from which it can be inferred that it will provide high-quality evidence of the effects in offspring BP of different subtypes of HDP [ 123 ].…”

Section: Consequences For the Offspringmentioning

confidence: 99%

Long-Term Consequences of Placental Vascular Pathology on the Maternal and Offspring Cardiovascular Systems

et al. 2021

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Over the last thirty years, evidence has been accumulating that Hypertensive Disorders of Pregnancy (HDP) and, specifically, Preeclampsia (PE) produce not only long-term effects on the pregnant woman, but have also lasting consequences for the fetus. At the core of these consequences is the phenomenon known as defective deep placentation, being present in virtually every major obstetrical syndrome. The profound placental vascular lesions characteristic of this pathology can induce long-term adverse consequences for the pregnant woman’s entire arterial system. In addition, placental growth restriction and function can, in turn, cause a decreased blood supply to the fetus, with long-lasting effects. Women with a history of HDP have an increased risk of Cardiovascular Diseases (CVD) compared with women with normal pregnancies. Specifically, these subjects are at a future higher risk of: Hypertension; Coronary artery disease; Heart failure; Peripheral vascular disease; Cerebrovascular accidents (Stroke); CVD-related mortality. Vascular pathology in pregnancy and CVD may share a common etiology and may have common risk factors, which are unmasked by the “stress” of pregnancy. It is also possible that the future occurrence of a CVD may be the consequence of endothelial dysfunction generated by pregnancy-induced hypertension that persists after delivery. Although biochemical and biophysical markers of PE abound, information on markers for a comparative evaluation in the various groups is still lacking. Long-term consequences for the fetus are an integral part of the theory of a fetal origin of a number of adult diseases, known as the Barker hypothesis. Indeed, intrauterine malnutrition and fetal growth restriction represent significant risk factors for the development of chronic hypertension, diabetes, stroke and death from coronary artery disease in adults. Other factors will also influence the development later in life of hypertension, coronary and myocardial disease; they include parental genetic disposition, epigenetic modifications, endothelial dysfunction, concurrent intrauterine exposures, and the lifestyle of the affected individual.

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Hypertensive disorders during pregnancy and elevated blood pressure in the offspring

Abstract: Supplemental Digital Content is available in the text

Cited by 9 publications

References 39 publications

Association between hypertensive disorders during pregnancy and elevated blood pressure in offspring: A systematic review and meta‐analysis

Association between hypertensive disorders during pregnancy and elevated blood pressure in offspring: A systematic review and meta‐analysis

Hypertension induced by pregnancy and neonatal outcome: Results from a retrospective cohort study in preterm under 34 weeks

Long-Term Consequences of Placental Vascular Pathology on the Maternal and Offspring Cardiovascular Systems

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