Impact of early- and late-onset preeclampsia on features of placental and newborn vascular health
Impact of early- and late-onset preeclampsia on features of placental and newborn vascular health
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DOI：
10.1016/j.placenta.2016.11.014
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发表时间：
2017-01-01
期刊：
影响因子：
3.8
通讯作者：
Steegers-Theunissen, Regine P. M.
中科院分区：
文献类型：
--
作者：
Herzog, Emilie M.;Eggink, Alex J.;Steegers-Theunissen, Regine P. M.
简介：暴露于先兆子痫（PE）的后代显示成年后心血管疾病的风险增加。我们假设这是由胎盘、脐带和胎儿的血管发育紊乱介导的。因此，我们研究了早发性PE（EOPE）、晚发性PE（LOPE）与胎盘和新生儿血管健康特征之间的关系。我们在鹿特丹围受孕队列中进行了一项巢式病例对照研究，包括30例PE妊娠（15例EOPE，15例LOPE）和218例对照妊娠（164例无并发症对照，54例并发症对照，包括28例胎儿生长受限，26例早产），并评估胎盘和脐带的宏观和组织形态学结果。PE与较小的脐静脉面积和壁厚之间存在显著相关性，与胎龄和出生体重无关。在EOPE中，我们观察到与较低的体重，胎盘的长度和宽度，脐带的长度，脐静脉和动脉的厚度和壁面积显着相关。这些关联在胎龄和出生体重调整后减弱。在LOPE一个显着的关联与一个较大的胎盘宽度和较小的脐静脉壁厚显示，独立的胎龄和出生weight.Discussion：我们的研究表明，PE是与一个较小的脐带静脉面积和壁厚，独立的胎龄和出生体重，这可能是作为一个代理在新生儿心血管发育紊乱。后续研究需要最终预测和降低暴露于PE的后代患心血管疾病的风险。(C)2016年6月，作者。由爱思唯尔有限公司出版。这是一篇在CC BY-NC-ND许可证下的开放获取文章（http：//creativecommons.org/licenses/by-nc-nd/4.0/）。
Introduction: Offspring exposed to preeclampsia (PE) show an increased risk of cardiovascular disease in adulthood. We hypothesize that this is mediated by a disturbed vascular development of the placenta, umbilical cord and fetus. Therefore, we investigated associations between early-onset PE (EOPE), late-onset PE (LOPE) and features of placental and newborn vascular health.Methods: We performed a nested case-control study in The Rotterdam Periconceptional Cohort, including 30 PE pregnancies (15 EOPE, 15 LOPE) and 218 control pregnancies (164 uncomplicated controls, 54 complicated controls including 28 fetal growth restriction, 26 preterm birth) and assessed macroscopic and histomorphometric outcomes of the placenta and umbilical cord.Results: A significant association was observed between PE and a smaller umbilical vein area and wall thickness, independent of gestational age and birth weight. In EOPE we observed significant associations with a lower weight, length and width of the placenta, length of the umbilical cord, and thickness and wall area of the umbilical vein and artery. These associations attenuated after gestational age and birth weight adjustment. In LOPE a significant association with a larger placental width and smaller umbilical vein wall thickness was shown, independent of gestational age and birth weight.Discussion: Our study suggests that PE is associated with a smaller umbilical cord vein area and wall thickness, independent of gestational age and birth weight, which may serve as a proxy of disturbed cardiovascular development in the newborn. Follow-up studies are needed to ultimately predict and lower the risk of cardiovascular disease in offspring exposed to PE. (C) 2016 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).