Preterm birth with antenatal corticosteroid administration has injurious and persistent effects on the structure and composition of the aorta and pulmonary artery

Bensley, Jonathan G.; Matteo, Robert De; Harding, Richard; Black, M. Jane

doi:10.1038/pr.2011.29

Cited by 21 publications

(21 citation statements)

References 33 publications

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“…Nevertheless, we found that antenatal glucocorticoid exposure is associated with a localised increase in aortic arch stiffness in preterm-born young adults, similar in magnitude to term-born individuals a decade older [16]. This is in line with findings in animal models, which have demonstrated a specific effect of antenatal glucocorticoid exposure on connective tissue accumulation and arrangement within the aortic wall in late gestation [48].…”

Section: Antenatal Glucocorticoidssupporting

confidence: 90%

Preeclampsia, prematurity and cardiovascular health in adult life

Lewandowski

Leeson

2014

Early Human Development

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Section: Antenatal Glucocorticoidssupporting

confidence: 90%

Preeclampsia, prematurity and cardiovascular health in adult life

Lewandowski

Leeson

2014

Early Human Development

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“…Interestingly, we reported that neonatal oxidative stress plays a key role in programming elevated blood pressure and vascular dysfunction in the low protein diet model [57]. In another study, preadolescent normotensive lambs (9 weeks) which had been delivered prematurely (at 0.9 gestation) show remodeling of the aortic wall with increased thickness, increased elastin deposition, reduced smooth muscle content but unchanged collagen content [24]. Differences between these studies and the current report are not all elucidated but can be related to differing type of stressor (restricted diet vs. oxygen), timing of insult, and species studied.…”

Section: Discussionmentioning

confidence: 90%

“…The area of the tunica media was calculated by subtracting the first area from the second area. Secondly, the density of elastin fibres (Verhoeff-Van Gieson stain) and of collagen fibres (Masson's trichrome stain) were quantified using the image analysis software (as above) and the ratio of their respective densities to the surface of the tunica media area was calculated [24]. Three to four series of sections per rat were studied and averaged.…”

Section: Methodsmentioning

confidence: 99%

Remodeling of Aorta Extracellular Matrix as a Result of Transient High Oxygen Exposure in Newborn Rats: Implication for Arterial Rigidity and Hypertension Risk

et al. 2014

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Neonatal high-oxygen exposure leads to elevated blood pressure, microvascular rarefaction, vascular dysfunction and arterial (aorta) rigidity in adult rats. Whether structural changes are present in the matrix of aorta wall is unknown. Considering that elastin synthesis peaks in late fetal life in humans, and early postnatal life in rodents, we postulated that transient neonatal high-oxygen exposure can trigger premature vascular remodelling. Sprague Dawley rat pups were exposed from days 3 to 10 after birth to 80% oxygen (vs. room air control) and were studied at 4 weeks. Blood pressure and vasomotor response of the aorta to angiotensin II and to the acetylcholine analogue carbachol were not different between groups. Vascular superoxide anion production was similar between groups. There was no difference between groups in aortic cross sectional area, smooth muscle cell number or media/lumen ratio. In oxygen-exposed rats, aorta elastin/collagen content ratio was significantly decreased, the expression of elastinolytic cathepsin S was increased whereas collagenolytic cathepsin K was decreased. By immunofluorescence we observed an increase in MMP-2 and TIMP-1 staining in aortas of oxygen-exposed rats whereas TIMP-2 staining was reduced, indicating a shift in the balance towards degradation of the extra-cellular matrix and increased deposition of collagen. There was no significant difference in MMP-2 activity between groups as determined by gelatin zymography. Overall, these findings indicate that transient neonatal high oxygen exposure leads to vascular wall alterations (decreased elastin/collagen ratio and a shift in the balance towards increased deposition of collagen) which are associated with increased rigidity. Importantly, these changes are present prior to the elevation of blood pressure and vascular dysfunction in this model, and may therefore be contributory.

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“…Subsequent to studies in the sheep describing the effect of preterm birth on the developing cardiovascular system , two clinical studies have compared cardiac growth and function in young adults born either preterm or term, using magnetic resonance imaging (MRI) . In the first of these two studies, it was shown that preterm birth was associated with an increase in left ventricular wall mass, abnormal wall geometry (a reduced internal chamber diameter, the left ventricular free wall was shorter, and the apex of the left ventricle was no longer centered normally), and systolic and diastolic dysfunction in the left ventricle.…”

Section: Introductionmentioning

confidence: 99%

The effects of preterm birth and its antecedents on the cardiovascular system

Bensley

Matteo

Harding

et al. 2016

Acta Obstet Gynecol Scand

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Introduction. Preterm birth occurs in approximately 10% of all births worldwide. It prematurely exposes the developing cardiovascular system to the hemodynamic transition that occurs at birth and to the subsequent functional demands of life ex utero. This review describes the current knowledge of the effects of preterm birth, and some of its common antecedents (chorioamnionitis, intra-uterine growth restriction, and maternal antenatal corticosteroid administration), on the structure of the myocardium. Material and methods. A thorough literature search was conducted for articles relating to how preterm birth, and its antecedents, affect development of the heart. Given that sheep are an excellent model for the studies of cardiac development, this review has focused on experimental studies in sheep as well as clinical findings. Results. Our review of the literature demonstrates that individuals born preterm are at an increased risk of cardiovascular disease later in life, including increased mean arterial pressure, abnormally shaped and sub-optimally performing hearts and changes in the vasculature. The review highlights how antenatal corticosteroids, intra-uterine growth restriction, and exposure to chorioamnionitis also have the potential to impact cardiac growth in the preterm newborn. Conclusions. Preterm birth and its common antecedents (antenatal corticosteroids, intra-uterine growth restriction, and chorioamnionitis) have the potential to adversely impact cardiac structure immediately following birth and in later life.

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Preterm birth with antenatal corticosteroid administration has injurious and persistent effects on the structure and composition of the aorta and pulmonary artery

Cited by 21 publications

References 33 publications

Preeclampsia, prematurity and cardiovascular health in adult life

Preeclampsia, prematurity and cardiovascular health in adult life

Remodeling of Aorta Extracellular Matrix as a Result of Transient High Oxygen Exposure in Newborn Rats: Implication for Arterial Rigidity and Hypertension Risk

The effects of preterm birth and its antecedents on the cardiovascular system

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