Pre-pregnancy check-up of maternal vascular status and associated phenotype is crucial for the health of mother and offspring

Abstract

Cardiovascular disease remains the leading cause of disease burden globally with far-reaching consequences including enormous socio-economic burden to healthcare and society at large. Cardiovascular health is decisive for reproductive function, healthy pregnancy and postpartum. During pregnancy, maternal cardiovascular system is exposed to highly increased haemodynamic stress that significantly impacts health status of the mother and offspring. Resulting from sub-optimal maternal health conditions overlooked in pre-pregnancy time, progressive abnormalities can be expected during pregnancy and postpartum. Contextually, there are two main concepts to follow in the framework of predictive, preventive and personalised medicine, namely to develop: 1. advanced screening of sub-optimal health conditions in young populations to predict and prevent individual health risks prior to planned pregnancies 2. in-depth companion diagnostics during pregnancy to predict and prevent long-lasting postpartum health risks of the mother and offspring. Data collected in the current study demonstrate group-specific complications to health of the mother and offspring and clinical relevance of the related phenotyping in pre-pregnant mothers. Diagnostic approach proposed in this study revealed its great clinical utility demonstrating important synergies between cardiovascular maladaptation and connective tissue dysfunction. Co-diagnosed pre-pregnancy low BMI of the mother, connective tissue dysfunction, increased stiffness of peripheral vessels and decreased blood pressure are considered a highly specific maternal phenotype useful for innovative screening programmes in young populations to predict and prevent severe risks to health of the mother and offspring. This crucial discovery brings together systemic effects characteristic, for example, for individuals with Flammer syndrome predisposed to the phenotype-specific primary vascular dysregulation, pregnancy-associated risks, normal tension glaucoma, ischemic stroke at young age, impaired wound healing and associated disorders. Proposed maternal phenotyping is crucial to predict and effectively protect both the mother and offspring against health-to-disease transition. Pre-pregnancy check-up focused on sub-optimal health and utilising here described phenotypes is pivotal for advanced health policy. Plain English abstract Cardiovascular health is decisive for reproductive function and healthy pregnancy. During pregnancy, maternal cardiovascular system may demonstrate health-to-disease transition relevant for the affected mother and offspring. Overlooked in pre-pregnancy time, progressive abnormalities can be expected during pregnancy and lifelong. Here we co-diagnosed maternal pre-pregnancy low bodyweight with systemic effects which may increase risks of pregnancy, eye and heart disorders and ischemic stroke at young age, amongst others. Innovative screening programmes focused on sub-optimal health in young populations to predict and to mitigate individual health risks prior to pregnancy is an essential innovation for health policy proposed.

Ischemic stroke of unclear aetiology: a case-by-case analysis and call for a multi-professional predictive, preventive and personalised approach

“…-Oxidative stress -Disturbed microcirculation -Endothelial dysfunction (ET-1) -Compromised mitochondrial health -Pro-inflammation -Connective tissue impairments -Extensive tissue remodelling, amongst other, collectively leading to the vicious cycle in the development of the systemic hypoxia-reperfusion, ischemic lesions, activated MMPs, blood brain barrier (BBB) breakdown, brain infarction and metastases [44][45][46][47][48].…”

Antithrombotic and antiplatelet effects of plant-derived compounds: a great utility potential for primary, secondary, and tertiary care in the framework of 3P medicine

“…To this end, sub-optimal maternal health conditions overlooked in pre-pregnancy time may lead to progressive abnormalities in the fetal development and maternal health status during pregnancy and postpartum. Recently published study "Pre-pregnancy check-up of maternal vascular status and associated phenotype is crucial for the health of mother and offspring" investigated maternal pre-pregnancy low BMI and Flammer syndrome phenotype which were co-diagnosed with the connective tissue dysfunction, increased stiffness of peripheral vessels and concomitant systemic effects increasing risks of ischemic stroke at a young age, among others [175]. Contextually, Flammer syndrome phenotyping has been strongly recommended for PPPM-relevant pre-pregnancy check-up as well as an application of natural substances in primary and secondary care to mitigate associated health risks of the affected mother and offspring [175].…”

“…Recently published study "Pre-pregnancy check-up of maternal vascular status and associated phenotype is crucial for the health of mother and offspring" investigated maternal pre-pregnancy low BMI and Flammer syndrome phenotype which were co-diagnosed with the connective tissue dysfunction, increased stiffness of peripheral vessels and concomitant systemic effects increasing risks of ischemic stroke at a young age, among others [175]. Contextually, Flammer syndrome phenotyping has been strongly recommended for PPPM-relevant pre-pregnancy check-up as well as an application of natural substances in primary and secondary care to mitigate associated health risks of the affected mother and offspring [175]. The detailed analysis demonstrated positive effects of phytochemicals protecting against oxidative stress, endothelial dysfunction, connective tissue dysfunction, small vessels disease and pro-inflammatory conditions -all involved in the pathomechanisms underlying CVST and ischemic stroke [175,176].…”

“…Contextually, Flammer syndrome phenotyping has been strongly recommended for PPPM-relevant pre-pregnancy check-up as well as an application of natural substances in primary and secondary care to mitigate associated health risks of the affected mother and offspring [175]. The detailed analysis demonstrated positive effects of phytochemicals protecting against oxidative stress, endothelial dysfunction, connective tissue dysfunction, small vessels disease and pro-inflammatory conditions -all involved in the pathomechanisms underlying CVST and ischemic stroke [175,176].…”

Comparison of Low Back Pain in Working and Non-Working Pregnant Females

“…(9,10) Using the Oswestry scale, compare the prevalence of low back pain in working versus non-working women, so that working women can take as much time off from their job/work area as possible to alleviate their back pains with more rest. (11) Second, it has been observed pregnant, non-working patients with back problems. A known relationship between back pain and non-working women with pregnancy would open the door to further investigation and pin point preventive and treatment protocols.…”