Login Register Cart 0
Generic placeholder image

Current Pediatric Reviews

Editor-in-Chief

ISSN (Print): 1573-3963
ISSN (Online): 1875-6336

Back
Journal Home About Journal Editorial Board Journal Insight Current Issue Volumes/Issues
Subscribe
Review Article

Preeclampsia Emerging as a Novel Risk Factor for Cardiovascular Disease in the Offspring

Author(s): Ageliki A. Karatza* and Gabriel Dimitriou

Volume 16, Issue 3, 2020

Page: [194 - 199] Pages: 6

DOI: 10.2174/1573396316666191224092405

Abstract

Introduction: Preeclampsia is a pregnancy specific disorder which affects 2%-8% of all gestations and is associated with high maternal, fetal and neonatal morbidity and mortality worldwide. There is no “cure” for the disease except for early delivery of the fetus and placenta, however leaving preeclampsia a long term health risk both for mothers and infants.

Aim: The aim of the study is to review currently available information linking preclampsia to longterm cardiovascular complications in infants and children.

Results: Currently, there is evidence of predisposition to cardiovascular disease, and a higher incidence of cardiovascular risk factors among children born to preeclamptic mothers. Both in experimental models and human epidemiological studies it is now clear that the infants of pregnancies complicated by preeclampsia have an increased risk of developing high blood pressure and double the risk of stroke in later life. Preeclampsia is consistently associated with higher blood pressure and body mass index as early as 4–10 years of age. Also there is some evidence of higher cardiovascular risk in adults exposed to maternal hypertensive disorders of pregnancy. It seems that preeclampsia has an impact on the cardiovascular system independent of preterm birth and is associated with endothelial dysfunction, increased carotid intima media thickness and reductions in cardiac function that cannot be accounted for by prematurity alone.

Conclusion: Taking into consideration the currently available evidence, it can now be suggested that preeclampsia is linked to adverse effects on the cardiometabolic health of the infant. Understanding the relationship between preeclampsia and cardiovascular disease will allow for implementation of early interventions to prevent or delay the onset of adverse events in this high risk population.

Keywords: Preeclampsia, offspring, cardiovascular disease, blood pressure, prevention, cardiovascular risk factors.

« Previous Next »
Graphical Abstract

[1]
Mol BWJ, Roberts CT, Thangaratinam S, Magee LA, de Groot CJM, Hofmeyr GJ. Pre-eclampsia. Lancet 2016; 387(10022): 999-1011. [http://dx.doi.org/10.1016/S0140-6736(15)00070-7]. [PMID: 26342729].
[2]
Jido TA, Yakasai IA. Preeclampsia: a review of the evidence. Ann Afr Med 2013; 12(2): 75-85. [http://dx.doi.org/10.4103/1596-3519.112395]. [PMID: 23713013].
[3]
Wallis AB, Saftlas AF, Hsia J, Atrash HK. Secular trends in the rates of preeclampsia, eclampsia, and gestational hypertension, United States, 1987-2004. Am J Hypertens 2008; 21(5): 521-6. [http://dx.doi.org/10.1038/ajh.2008.20]. [PMID: 18437143].
[4]
Jim B, Karumanchi SA. Preeclampsia: Pathogenesis, Prevention, and Long-Term Complications. Semin Nephrol 2017; 37(4): 386-97. [http://dx.doi.org/10.1016/j.semnephrol.2017.05.011]. [PMID: 28711078].
[5]
Amaral LM, Wallace K, Owens M, LaMarca B. Pathophysiology and Current Clinical Management of Preeclampsia. Curr Hypertens Rep 2017; 19(8): 61. [http://dx.doi.org/10.1007/s11906-017-0757-7]. [PMID: 28689331].
[6]
Goffin SM, Derraik JGB, Groom KM, Cutfield WS. Maternal pre-eclampsia and long-term offspring health: Is there a shadow cast? Pregnancy Hypertens 2018; 12: 11-5. [http://dx.doi.org/10.1016/j.preghy.2018.02.003]. [PMID: 29674189].
[7]
Report of the American College of Obstetricians and Gynecologists’ Task Force on Hypertension in Pregnancy. Hypertension in Pregnancy: Executive Summary. Obstet Gynecol 2013; 122: 1122-31.
[8]
Wu P, Haththotuwa R, Kwok CS, et al. Preeclampsia and Future Cardiovascular Health: A Systematic Review and Meta-Analysis. Circ Cardiovasc Qual Outcomes 2017; 10(2)e003497 [http://dx.doi.org/10.1161/CIRCOUTCOMES.116.003497]. [PMID: 28228456].
[9]
Mosca L, Benjamin EJ, Berra K, et al. Effectiveness-based guidelines for the prevention of cardiovascular disease in women--2011 update: a guideline from the american heart association. Circulation 2011; 123(11): 1243-62. [http://dx.doi.org/10.1161/CIR.0b013e31820faaf8]. [PMID: 21325087].
[10]
Piepoli MF, Hoes AW, Agewall S, et al. 2016 European Guidelines on cardiovascular disease prevention in clinical practice: The Sixth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of 10 societies and by invited experts)Developed with the special contribution of the European Association for Cardiovascular Prevention & Rehabilitation (EACPR). Eur Heart J 2016; 37(29): 2315-81. [http://dx.doi.org/10.1093/eurheartj/ehw106]. [PMID: 27222591].
[11]
Pauli JM, Repke JT. Preeclampsia. Short and long-term implications. Obstet Gynecol Clin North Am 2015; 42(2): 299-313. [http://dx.doi.org/10.1016/j.ogc.2015.01.007]. [PMID: 26002168].
[12]
Nahum Sacks K, Friger M, Shoham-Vardi I, et al. Prenatal exposure to preeclampsia as an independent risk factor for long-term cardiovascular morbidity of the offspring. Pregnancy Hypertens 2018; 13: 181-6. [http://dx.doi.org/10.1016/j.preghy.2018.06.013]. [PMID: 30177050].
[13]
Story L, Chappell LC. Preterm pre-eclampsia: What every neonatologist should know. Early Hum Dev 2017; 114: 26-30. [http://dx.doi.org/10.1016/j.earlhumdev.2017.09.010]. [PMID: 28917582].
[14]
Backes CH, Markham K, Moorehead P, Cordero L, Nankervis CA, Giannone PJ. Maternal preeclampsia and neonatal outcomes. J Pregnancy 2011; •••2011214365 [http://dx.doi.org/10.1155/2011/214365]. [PMID: 21547086].
[15]
Amaral LM, Cunningham MW Jr, Cornelius DC, LaMarca B. Preeclampsia: long-term consequences for vascular health. Vasc Health Risk Manag 2015; 11: 403-15.
[16]
Figueiró-Filho EA, Mak LE, Reynolds JN, et al. Neurological function in children born to preeclamptic and hypertensive mothers - A systematic review. Pregnancy Hypertens 2017; 10: 1-6. [http://dx.doi.org/10.1016/j.preghy.2017.07.144]. [PMID: 29153658].
[17]
Lazdam M, de la Horra A, Pitcher A, et al. Elevated blood pressure in offspring born premature to hypertensive pregnancy: is endothelial dysfunction the underlying vascular mechanism? Hypertension 2010; 56(1): 159-65. [http://dx.doi.org/10.1161/HYPERTENSIONAHA.110.150235]. [PMID: 20479334].
[18]
Thoulass JC, Robertson L, Denadai L, et al. Hypertensive disorders of pregnancy and adult offspring cardiometabolic outcomes: a systematic review of the literature and meta-analysis. J Epidemiol Community Health 2016; 70(4): 414-22. [http://dx.doi.org/10.1136/jech-2015-205483]. [PMID: 26347276].
[19]
Kajantie E, Eriksson JG, Osmond C, Thornburg K, Barker DJ. Pre-eclampsia is associated with increased risk of stroke in the adult offspring: the Helsinki birth cohort study. Stroke 2009; 40(4): 1176-80. [http://dx.doi.org/10.1161/STROKEAHA.108.538025]. [PMID: 19265049].
[20]
Davis EF, Lazdam M, Lewandowski AJ, et al. Cardiovascular risk factors in children and young adults born to preeclamptic pregnancies: a systematic review. Pediatrics 2012; 129(6): e1552-61. [http://dx.doi.org/10.1542/peds.2011-3093]. [PMID: 22614768].
[21]
Pinheiro TV, Brunetto S, Ramos JG, Bernardi JR, Goldani MZ. Hypertensive disorders during pregnancy and health outcomes in the offspring: a systematic review. J Dev Orig Health Dis 2016; 7(4): 391-407. [http://dx.doi.org/10.1017/S2040174416000209]. [PMID: 27168118].
[22]
Rice MM, Landon MB, Varner MW, et al. Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) Maternal-Fetal Medicine Units (MFMU) Network. Pregnancy-Associated Hypertension and Offspring Cardiometabolic Health. Obstet Gynecol 2018; 131(2): 313-21. [http://dx.doi.org/10.1097/AOG.0000000000002433]. [PMID: 29324603].
[23]
Lewandowski AJ, Augustine D, Lamata P, et al. Preterm heart in adult life: cardiovascular magnetic resonance reveals distinct differences in left ventricular mass, geometry, and function. Circulation 2013; 127(2): 197-206. [http://dx.doi.org/10.1161/CIRCULATIONAHA.112.126920]. [PMID: 23224059].
[24]
Lewandowski AJ, Leeson P. Preeclampsia, prematurity and cardiovascular health in adult life. Early Hum Dev 2014; 90(11): 725-9. [http://dx.doi.org/10.1016/j.earlhumdev.2014.08.012]. [PMID: 25209092].
[25]
McDonald SD, Malinowski A, Zhou Q, Yusuf S, Devereaux PJ. Cardiovascular sequelae of preeclampsia/eclampsia: a systematic review and meta-analyses. Am Heart J 2008; 156(5): 918-30. [http://dx.doi.org/10.1016/j.ahj.2008.06.042]. [PMID: 19061708].
[26]
Lazdam M, de la Horra A, Diesch J, et al. Unique blood pressure characteristics in mother and offspring after early onset preeclampsia. Hypertension 2012; 60(5): 1338-45. [http://dx.doi.org/10.1161/HYPERTENSIONAHA.112.198366]. [PMID: 23045462].
[27]
Alsnes IV, Vatten LJ, Fraser A, et al. Hypertension in Pregnancy and Offspring Cardiovascular Risk in Young Adulthood: Prospective and Sibling Studies in the HUNT Study (Nord-Trøndelag Health Study) in Norway. Hypertension 2017; 69(4): 591-8. [http://dx.doi.org/10.1161/HYPERTENSIONAHA.116.08414]. [PMID: 28223467].
[28]
Tong W, Xue Q, Li Y, Zhang L. Maternal hypoxia alters matrix metalloproteinase expression patterns and causes cardiac remodeling in fetal and neonatal rats. Am J Physiol Heart Circ Physiol 2011; 301(5): H2113-21. [http://dx.doi.org/10.1152/ajpheart.00356.2011]. [PMID: 21856922].
[29]
Børke WB, Edvardsen T, Fugelseth D, et al. Reduced left ventricular function in hypoxemic newborn pigs: a strain Doppler echocardiographic study. Pediatr Res 2006; 59(5): 630-5. [http://dx.doi.org/10.1203/01.pdr.0000214846.00318.36]. [PMID: 16627872].
[30]
de la Calzada DG, García LO, Remírez JM, Lázaro A, Cajal MD. Study of early detection of cardiovascular risk factors in children born small (SGA) and review of literature. Pediatr Endocrinol Rev 2009; 6(Suppl. 3): 343-9.
[31]
Barker DJ, Larsen G, Osmond C, Thornburg KL, Kajantie E, Eriksson JG. The placental origins of sudden cardiac death. Int J Epidemiol 2012; 41(5): 1394-9. [http://dx.doi.org/10.1093/ije/dys116]. [PMID: 22997261].
[32]
Stojanovska V, Scherjon SA, Plösch T. Preeclampsia as modulator of offspring health. Biol Reprod 2016; 94(3): 53. [http://dx.doi.org/10.1095/biolreprod.115.135780]. [PMID: 26792940].
[33]
Herrera-Garcia G, Contag S. Maternal preeclampsia and risk for cardiovascular disease in offspring. Curr Hypertens Rep 2014; 16(9): 475. [http://dx.doi.org/10.1007/s11906-014-0475-3]. [PMID: 25097112].
[34]
Davis EF, Newton L, Lewandowski AJ, et al. Pre-eclampsia and offspring cardiovascular health: mechanistic insights from experimental studies. Clin Sci (Lond) 2012; 123(2): 53-72. [http://dx.doi.org/10.1042/CS20110627]. [PMID: 22455350].
[35]
Bao W, Threefoot SA, Srinivasan SR, Berenson GS. Essential hypertension predicted by tracking of elevated blood pressure from childhood to adulthood: the Bogalusa Heart Study. Am J Hypertens 1995; 8(7): 657-65. [http://dx.doi.org/10.1016/0895-7061(95)00116-7]. [PMID: 7546488].
[36]
D’Agostino RB Sr, Vasan RS, Pencina MJ, et al. General cardiovascular risk profile for use in primary care: the Framingham Heart Study. Circulation 2008; 117(6): 743-53. [http://dx.doi.org/10.1161/CIRCULATIONAHA.107.699579]. [PMID: 18212285].
[37]
Expert panel on integrated guidelines for cardiovascular health and risk reduction in children and adolescents: summary report. Pediatrics 2011; 128(Suppl. 5): S213-56. [http://dx.doi.org/10.1542/peds.2009-2107C]. [PMID: 22084329].

Rights & Permissions Print Cite
Article Metrics
40
1
World Autism Awareness Day
© 2024 Bentham Science Publishers | Privacy Policy