Preterm birth with placental evidence of malperfusion is associated with cardiovascular risk factors after pregnancy: a prospective cohort study.
Preterm birth with placental evidence of malperfusion is associated with cardiovascular risk factors after pregnancy: a prospective cohort study.
复制标题
DOI：
10.1111/1471-0528.15040
复制
发表时间：
2018-07
期刊：
影响因子：
--
通讯作者：
Parks WT
中科院分区：
文献类型：
--
作者：
Catov JM;Muldoon MF;Reis SE;Ness RB;Nguyen LN;Yamal JM;Hwang H;Parks WT
早产（PTB）与孕产妇心血管疾病风险过高相关。我们认为，患有 PTB 且有胎盘证据表明母亲灌注不良的女性尤其会受到影响。妊娠队列研究。美国宾夕法尼亚州匹兹堡 患有 PTB (n=115) 和足月产 (n=210) 的女性在怀孕后 4-12 年进行评估。对既往有过 PTB 的妇女与足月产妇的心脏代谢风险标记进行了比较；先兆子痫和生长受限病例被排除。母体血管灌注不良（血管病变、梗塞、绒毛成熟提前、绒毛周围纤维蛋白、绒毛间纤维蛋白沉积）、急性感染/炎症（绒毛膜羊膜炎、兔兔炎、蜕膜）和病因不明的绒毛炎（慢性炎症）的胎盘证据用于对 PTB 进行分类。产后测量颈动脉内膜中层厚度（IMT）、空腹血脂、血压（BP）和炎症标志物。考虑到年龄、种族、孕前 BMI 和吸烟情况，患有 PTB 和灌注不良病变的女性在随访时的总胆固醇 (+13.5 mg/dl) 和收缩压 (+4.0 mmHg) 高于足月产女性 (p<0.05)。患有 PTB 和灌注不良并伴有炎症病变的女性在怀孕后具有最严重的动脉粥样硬化特征（胆固醇 +18.7，载脂蛋白 B +12.7 mg/dl；所有 p<0.05），根据怀孕前特征进行调整。考虑到孕前因素，该组的颈动脉 IMT 较高（+0.037 cm，p=0.031）；随访时调整血压和致动脉粥样化脂质后，差异减弱（+0.027，p=0.095）。胎盘灌注不良的 PTB 与怀孕后十年内母亲心脏代谢风险负担过高有关。胎盘可能有助于了解与孕产妇心血管疾病相关的 PTB 亚型。
Preterm birth (PTB) is associated with excess maternal cardiovascular disease risk. We considered that women with PTB and placental evidence of maternal malperfusion would be particularly affected. Pregnancy cohort study. Pittsburgh Pennsylvania, US Women with PTB (n=115) and term births (n=210) evaluated 4–12 years after pregnancy. Cardiometabolic risk markers were compared in women with prior PTB vs. term births; preeclampsia and growth restriction cases were excluded. Placental evidence of maternal vascular malperfusion (vasculopathy, infarct, advanced villous maturation, perivillous fibrin, intervillous fibrin deposition), acute infection/inflammation (chorioamnionitis, funisitis, deciduitus), and villitis of unknown etiology (chronic inflammation) was used to classify PTBs. Carotid artery intima-media thickness (IMT), fasting lipids, blood pressure (BP) and inflammatory markers measured after delivery. Women with PTB and malperfusion lesions had higher total cholesterol (+13.5 mg/dl) and systolic BP (+4.0 mmHg) at follow up compared to women with term births, accounting for age, race, pre-pregnancy BMI, and smoking (p<0.05). Women with PTB and malperfusion accompanied by inflammatory lesions had the most atherogenic profile after pregnancy (cholesterol +18.7, Apolipoprotein B +12.7 mg/dl; all p<0.05), adjusted for pre-pregnancy features. Carotid IMT was higher in this group (+0.037 cm, p=0.031) accounting for pre-pregnancy factors; differences were attenuated after adjusting for BP and atherogenic lipids at follow up (+0.027, p=0.095). PTBs with placental malperfusion were associated with an excess maternal cardiometabolic risk burden in the decade after pregnancy. The placenta may offer insight into subtypes of PTB related to maternal cardiovascular disease.
登录
查看更多内容
影响因子：
8.3
作者：
Lorenz, MW;von Kegler, S;Sitzer, M
通讯作者：
Sitzer, M
DOI：
10.1111/j.1600-0412.2012.01391.x
发表时间：
2012-06
影响因子：
4.3
作者：
Mudd LM;Holzman CB;Catov JM;Senagore PK;Evans RW
通讯作者：
Evans RW
影响因子：
9.8
作者：
Catov, Janet M.;Bodnar, Lisa M.;Roberts, James M.
通讯作者：
Roberts, James M.
影响因子：
1.9
作者：
Redline, RW;Boyd, T;Waters, BL
通讯作者：
Waters, BL
影响因子：
3.8
作者：
Catov, J. M.;Peng, Y.;Parks, W. T.
通讯作者：
Parks, W. T.