Maternal Preeclampsia and Risk for Cardiovascular Disease in Offspring

Herrera-Garcia, Guadalupe; Contag, Stephen

doi:10.1007/s11906-014-0475-3

Cited by 49 publications

(52 citation statements)

References 91 publications

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“…30,[35][36][37] However, it has also been suggested that excess cardiovascular risk in the offspring could be a longterm consequence of fetal exposure to preeclampsia. 30,31 In support of that possibility, another study using information from differentially exposed siblings found a marked vascular dysfunction (higher pulmonary artery pressure and smaller flow-mediated dilatation) in offspring of pregnancies with late-onset preeclampsia but normal vascular function in their siblings born after a normotensive pregnancy. 38 In this study, Mean differences in cardiovascular risk factors in adult offspring exposed to maternal hypertensive disorder compared with their unexposed siblings, adjusted for age, sex, maternal parity, and HUNT (Nord-Trøndelag Health Study) survey.…”

Section: Discussionmentioning

confidence: 96%

“…28,29 An intriguing question is whether the adverse cardiovascular risk profile can be attributed to genetic or behavioral risk factors common to mothers and their offspring or to intrauterine vascular damage or altered metabolism caused by fetal exposure to hypertension or preeclampsia. [30][31][32] There is evidence that preeclampsia and CVD share similar risk factors 33 and that cardiovascular risk factors before pregnancy seem to be positively associated with preeclampsia risk. 34 We found that the positive associations of hypertensive pregnancy disorders with offspring blood pressure and BMI were substantially attenuated after accounting for maternal blood pressure and BMI.…”

Section: Discussionmentioning

confidence: 99%

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Hypertension in Pregnancy and Offspring Cardiovascular Risk in Young Adulthood

et al. 2017

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H ypertensive disorders of pregnancy include gestational hypertension and preeclampsia.1 In addition to hypertension, preeclampsia is characterized by proteinuria and is a leading cause of maternal and perinatal morbidity. [2][3][4] It is well established that women with a history of hypertension in pregnancy are at increased risk of cardiovascular disease (CVD) later in life, [5][6][7][8] and their offspring may also have an increased lifetime risk of CVD.9-11 Children and adolescents whose mothers had preeclampsia seem to have higher body mass index (BMI) and blood pressure than others, but it is not entirely clear whether other cardiovascular risk factors, such as serum lipids, may also differ.12 Also, it remains to be determined whether siblings born after a hypertensive pregnancy differ in their cardiovascular profile compared with siblings born after a normotensive pregnancy. Such an analysis might help clarify whether the children's risk factors could be attributed to the hypertensive pregnancy or whether shared genes or shared lifestyle are equally relevant.Using a prospective cohort design, we investigated whether intrauterine exposure to maternal hypertensive disorders (gestational hypertension, term preeclampsia, or preterm preeclampsia) is associated with cardiovascular risk factors Abstract-Women with hypertensive disorders in pregnancy are at increased lifetime risk for cardiovascular disease. We examined the offspring's cardiovascular risk profile in young adulthood and their siblings' cardiovascular risk profile. From the HUNT study (Nord-Trøndelag Health Study) in Norway, 15 778 participants (mean age: 29 years), including 210 sibling groups, were linked to information from the Medical Birth Registry of Norway. Blood pressure, anthropometry, serum lipids, and C-reactive protein were assessed. Seven hundred and six participants were born after exposure to maternal hypertension in pregnancy: 336 mothers had gestational hypertension, 343 had term preeclampsia, and 27 had preterm preeclampsia. Offspring whose mothers had hypertension in pregnancy had 2.7 (95% confidence interval, 1.8-3.5) mm Hg higher systolic blood pressure, 1.5 (0.9-2.1) mm Hg higher diastolic blood pressure, 0.66 (0.31-1.01) kg/m 2 higher body mass index, and 1.49 (0.65-2.33) cm wider waist circumference, compared with offspring of normotensive pregnancies. Similar differences were observed for gestational hypertension and term preeclampsia. Term preeclampsia was also associated with higher concentrations of non-high-density lipoprotein cholesterol (0.14 mmol/L, 0.03-0.25) and triglycerides (0.13 mmol/L, 0.06-0.21). Siblings born after a normotensive pregnancy had nearly identical risk factor levels as siblings born after maternal hypertension. Offspring born after maternal hypertension in pregnancy have a more adverse cardiovascular risk profile in young adulthood than offspring of normotensive pregnancies. Their siblings, born after a normotensive pregnancy, have a similar risk profile, suggesting that shared genes or lifestyle...

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Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

Hypertension in Pregnancy and Offspring Cardiovascular Risk in Young Adulthood

et al. 2017

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“…Babies born of pregnancies of women with preeclampsia demonstrate a higher incidence of hypertension in childhood and adolescence (Geelhoed et al, 2010). This increased risk of CVD may be related to a "direct effect, a familial aggregation of risk, or confounded by its association with intrauterine growth restriction" (Herrera-Garcia &Contag, 2014, p. 3). Fraser, Nelson, Macdonald-Wallis, Sattar, andLawlor (2013) found no strong evidence of associations between preeclampsia and gestational hypertension and fasting insulin, glucose, and lipids measured in the adolescent children of mothers who had been affected by these conditions during pregnancy; however, mean systolic BP and diastolic BP were elevated during their adolescence.…”

Section: Children Of Women Who Have Had Preeclampsia and Cvdmentioning

confidence: 99%

Cardiovascular Implications of Preeclampsia

Burgess

Founds

2016

McN: The American Journal of Maternal/Child Nursing

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Cardiovascular disease (CVD) is the leading cause of death of women in the United States. Many healthcare providers are unaware of sex-specific factors that affect the development of CVD. Nursing care for women with a history of preeclampsia and their children is presented. Preeclampsia affects 4% to 8% of all pregnancies. Rates have increased by 25% over the past 2 decades. Research supports the link between preeclampsia and risk of future CVD in women and the children of affected pregnancies. Appropriate preconception, prenatal and postpartum education, and surveillance are necessary to improve the long-term health of both mother and infant. Currently, there are no evidence-based interventions specific to the prevention of CVD for women and their children who have been affected by preeclampsia. However, women who have had preeclampsia may require yearly risk factor assessment and education regarding cardiovascular prevention strategies such as smoking cessation, increased physical activity, importance of a healthy diet, and maintenance of a healthy weight. Preeclampsia should be acknowledged by healthcare providers as a CVD risk factor. Appropriate monitoring, education, and CVD preventive strategies need to be implemented with this population and their children.

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“…Offspring of pregnancies complicated by placental ischemia, hypertension and preeclampsia exhibit a greater risk for the development of increased blood pressure ( BP ) (1, 2) and cardiovascular ( CV ) disease in later life (1, 3). A mechanical reduction in uteroplacental perfusion in the rat results in placental ischemia leading to hypertension in the mother and intrauterine growth restriction ( IUGR ) in the offspring (4).…”

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confidence: 99%

Sex-Specific Effect of Endothelin in the Blood Pressure Response to Acute Angiotensin II in Growth-Restricted Rats

et al. 2015

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The renal endothelin system contributes to sex differences in blood pressure with males demonstrating greater endothelin type-A receptor-mediated responses relative to females. Intrauterine growth restriction programs hypertension and enhanced renal sensitivity to acute angiotensin II in male growth-restricted rats. Endothelin is reported to work synergistically with angiotensin II. Thus, this study tested the hypothesis that endothelin augments the blood pressure response to acute angiotensin II in male growth-restricted rats. Systemic and renal hemodynamics were determined in response to acute angiotensin II (100 nanogram/kilogram/minute for 30 minutes) with and without the endothelin type-A receptor antagonist, ABT 627(10 nanogram/kilogram/minute for 30 minutes), in rats pretreated with enalapril (250 milligram/Liter for one week) to normalize the endogenous renin angiotensin system. Endothelin type-A receptor blockade reduced angiotensin II-mediated increases in blood pressure in male control and male growth-restricted rats. Endothelin type-A receptor blockade also abolished hyper-responsiveness to acute angiotensin II in male growth-restricted rats. Yet, blood pressure remained significantly elevated above baseline following endothelin type-A receptor blockade suggesting that factors in addition to endothelin contribute to the basic angiotensin II-induced pressor response in male rats. We also determined sex-specific effects of endothelin on acute angiotensin II-mediated hemodynamic responses. Endothelin type-A receptor blockade did not reduce acute angiotensin II-mediated increases in blood pressure in female control or growth-restricted rats, intact or ovariectomized. Thus, these data suggest that endothelin type-A receptor blockade contributes to hypersensitivity to acute angiotensin II in male growth-restricted rats and further supports the sex-specific effect of endothelin on blood pressure.

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Maternal Preeclampsia and Risk for Cardiovascular Disease in Offspring

Cited by 49 publications

References 91 publications

Hypertension in Pregnancy and Offspring Cardiovascular Risk in Young Adulthood

Hypertension in Pregnancy and Offspring Cardiovascular Risk in Young Adulthood

Cardiovascular Implications of Preeclampsia

Sex-Specific Effect of Endothelin in the Blood Pressure Response to Acute Angiotensin II in Growth-Restricted Rats

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