Heterogeneous causes constituting the single syndrome of preeclampsia: A hypothesis and its implications
Heterogeneous causes constituting the single syndrome of preeclampsia: A hypothesis and its implications
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DOI：
10.1016/s0002-9378(96)70056-x
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发表时间：
1996-11-01
影响因子：
9.8
通讯作者：
Roberts, JM
中科院分区：
文献类型：
--
作者：
Ness, RB;Roberts, JM
尽管许多人尝试了解先兆子痫的生物学特征并描述其预测因素，但其病因仍然难以捉摸。我们认为先兆子痫有不同的起源，每种都有其自己的病理特征和自然史。一种成因是胎盘灌注减少的结果，我们将其称为胎盘，另一种成因是怀孕前存在的母体疾病（但有时在怀孕前并不明显）。这些先前存在的母体疾病包括心血管疾病的诱发因素，例如高血压、肾病、超重和糖尿病。对流行病学和病理学文献进行了批判性回顾，支持先兆子痫是异质原因造成的假设。讨论了该假设的含义，特别是其对预测先兆子痫发生的规则的制定的影响。
The cause of preeclampsia remains elusive in spite of many attempts to understand its biologic characteristics and to characterize its predictors. We suggest that there are distinct origins of preeclampsia, each with its own pathologic characteristics and natural history. One genesis is the result of reduced placental perfusion, which we will call placental, and another results from maternal disorders preexisting (but sometimes not evident before) pregnancy. These preexisting maternal disorders comprise predisposing factors for cardiovascular disease such as hypertension, renal disease, overweight, and diabetes. A critical review of the epidemiologic and pathologic literature is presented, which supports the hypothesis that preeclampsia is the result of heterogeneous causes. The implications of this hypothesis are discussed, particularly its impact on the development of rules to predict the occurrence of preeclampsia.