Tenhola Sirpa, Rahiala Eero, Halonen Pirjo, Vanninen Esko, Voutilainen Raimo
Department of Pediatrics, Kuopio University and University Hospital, Finland.
Pediatr Res. 2006 Feb;59(2):320-4. doi: 10.1203/01.pdr.0000196734.54473.e3.
Ambulatory blood pressure (ABP) monitoring offers a reliable method for determining blood pressure (BP) in children. The aim of this cohort study was to examine whether maternal preeclampsia is associated with elevated BP in an offspring. The study population consisted of 57 children born to preeclamptic mothers (PRE) and their 57 age- and sex-matched control subjects born to normotensive mothers (non-PRE). We examined the 24-h ABP at 12 y of age in the PRE and non-PRE children. Within the two groups, the association of anthropometric measures, plasma catecholamine (epinephrine [E], norepinephrine [NE]) concentrations, and ABP was examined. The PRE children had significantly higher mean 24-h systolic and diastolic ABPs than the non-PRE children. The same was true for the mean daytime and nighttime systolic and diastolic ABPs. The PRE boys had higher 24-h systolic ABP than the PRE girls. In the PRE children, high plasma E concentration and being born small for gestational age (SGA) predicted high systolic 24-h ABP in logistic regression analysis. In the non-PRE children, high current body mass index (BMI) and high plasma E concentration was associated with high systolic 24-h ABP. In conclusion, systolic and diastolic ABP values were elevated in the PRE children. High plasma E concentration and being born SGA were associated with high systolic 24-h ABP in the PRE children. Presumably maternal preeclampsia affects offspring via several mechanisms, including genetic ones and metabolic consequences of restricted intrauterine growth.
动态血压(ABP)监测为测定儿童血压(BP)提供了一种可靠的方法。这项队列研究的目的是检验母亲子痫前期是否与后代血压升高有关。研究人群包括57名子痫前期母亲所生的儿童(PRE组)以及57名年龄和性别匹配的血压正常母亲所生的对照对象(非PRE组)。我们在PRE组和非PRE组儿童12岁时检测了他们的24小时动态血压。在两组内,研究了人体测量指标、血浆儿茶酚胺(肾上腺素[E]、去甲肾上腺素[NE])浓度与动态血压之间的关联。PRE组儿童的24小时平均收缩压和舒张压显著高于非PRE组儿童。日间和夜间的平均收缩压和舒张压情况也是如此。PRE组男孩的24小时收缩压高于PRE组女孩。在PRE组儿童中,在逻辑回归分析中,高血浆E浓度和小于胎龄儿(SGA)出生预测了24小时高收缩压。在非PRE组儿童中,高当前体重指数(BMI)和高血浆E浓度与24小时高收缩压相关。总之,PRE组儿童的收缩压和舒张压值升高。高血浆E浓度和SGA出生与PRE组儿童24小时高收缩压相关。推测母亲子痫前期通过多种机制影响后代,包括遗传机制和子宫内生长受限的代谢后果。