Shared constitutional risks for maternal vascular-related pregnancy complications and future cardiovascular disease
Shared constitutional risks for maternal vascular-related pregnancy complications and future cardiovascular disease
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DOI：
10.1161/hypertensionaha.107.101873
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发表时间：
2008-04-01
期刊：
影响因子：
8.3
通讯作者：
Steegers, Eric A. P.
中科院分区：
文献类型：
--
作者：
Berends, Anne L.;de Groot, Christianne J. M.;Steegers, Eric A. P.
母体易患血管和代谢疾病可能是血管相关妊娠并发症（如先兆子痫和宫内生长受限）以及未来母体心血管疾病的基础。我们的目的是通过在一个荷兰的隔离人群中进行一项代际病例对照研究，用生化和人体测量学证据来证实这一假设，该人群包括106名先兆子痫或宫内生长受限的妇女（中位随访时间：7.1岁）和他们的父亲（n = 43）和母亲（n = 64），以及106名对照受试者，他们的父亲（n = 51）和母亲（n = 68）在无并发症妊娠后。评估心血管风险特征，包括空腹血糖、血脂、人体测量学、血压、内膜中层厚度和代谢综合征。我们发现，与对照组相比，有先兆子痫病史的妇女空腹血糖水平显著升高，腰围增大，高血压患病率增加5倍（P < 0.001）。同样，他们的父母有较高的血糖水平比对照父母（P < 0.05）。母亲腰围较大，血压较高（P < 0.05）。妊娠合并胎儿宫内生长受限者血糖升高，高血压患病率增高（P < 0.01）。其父亲血糖水平也高于对照组（P < 0.05）。在子痫前期后诊断为慢性高血压的妇女中，平均颈动脉内膜中层厚度比无高血压的妇女增加（P < 0.01）。代谢综合征在有子痫前期病史的孕妇及其母亲中的患病率均高于无子痫前期病史的孕妇（P < 0.05）。我们证明了先兆子痫或宫内生长受限妇女及其父母之间心血管风险特征的代际相似性。这些发现表明血管相关妊娠并发症和未来心血管疾病的共同体质风险。
Maternal predisposition to vascular and metabolic disease may underlie both vascular-related pregnancy complications, such as preeclampsia and intrauterine growth restriction, as well as future maternal cardiovascular disease. We aimed to substantiate this hypothesis with biochemical and anthropometric evidence by conducting an intergenerational case-control study in a Dutch isolated population including 106 women after preeclampsia or intrauterine growth restriction (median follow-up: 7.1 years) and their fathers (n = 43) and mothers (n = 64), as well as 106 control subjects after uncomplicated pregnancies with their fathers (n = 51) and mothers (n = 68). Cardiovascular risk profiles were assessed, including fasting glucose, lipids, anthropometrics, blood pressure, intima-media thickness, and metabolic syndrome. We found significantly higher fasting glucose levels, larger waist circumferences, and a 5-fold increased prevalence of hypertension in women with a history of preeclampsia as compared with control subjects (P < 0.001). Likewise, their parents had higher glucose levels than control parents (P < 0.05). Their mothers had larger waist circumferences and higher blood pressures (P < 0.05). Also, women after pregnancies complicated by intrauterine growth restriction had higher glucose levels and increased prevalence of hypertension (P < 0.01). Their fathers showed higher glucose levels as well (P < 0.05). Mean carotid intima-media thickness was increased in a subset of women after preeclampsia diagnosed with chronic hypertension as compared with those without hypertension (P < 0.01). Metabolic syndrome was more prevalent both in women with a history of preeclampsia and their mothers (P < 0.05). We demonstrated intergenerational similarities in cardiovascular risk profiles between women after preeclampsia or intrauterine growth restriction and their parents. These findings suggest shared constitutional risks for vascular-related pregnancy complications and future cardiovascular disease.