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子痫前期孕妇的新生儿:子宫内存在的生化差异。

Newborns of pre-eclamptic women: a biochemical difference present in utero.

作者信息

Ophir Ella, Dourleshter Gregory, Hirsh Yael, Fait Vladimir, German Leonid, Bornstein Jacob

机构信息

Department of Obstetrics and Gynecology, Western Galilee Hospital, Technion University. P.O. Box 21, Nahariya 21000, Israel.

出版信息

Acta Obstet Gynecol Scand. 2006;85(10):1172-8. doi: 10.1080/00016340600697272.

Abstract

BACKGROUND

Offspring exposed to pre-eclampsia in utero had higher systolic blood pressure, and were more obese during adolescence. We hypothesized that metabolic changes, a marker of cardiovascular disease, may be affected by intrauterine exposure to pre-eclampsia.

METHODS

Blood samples were collected from cord blood of 36 newborns who were exposed to pre-eclampsia in utero and their mothers, and of 35 newborns and their mothers with noncomplicated pregnancies. Serum levels of lipids, homocysteine, and fibrinogen were determined in all samples.

RESULTS

Fetuses exposed to pre-eclampsia in utero had lower birth weight, smaller abdominal circumference (p<0.002; p<0.03 respectively) and higher levels of low-density lipoprotein, homocysteine, and fibrinogen (p<0.01; p<0.001; p<0.001, respectively), compared with fetuses of normotensive, pregnancies. A significant correlation existed between maternal homocysteine concentration and that of newborn infants (r=0.539; p<0.001) and between maternal low-density lipoprotein and newborn homocysteine (r=0.36; p<0.03). Significant negative correlations were found between abdominal circumference of newborns and cord blood concentration of fibrinogen (r= - 0.52; p<0.001) and low-density lipoprotein (r= - 0.42; p<0.001). Maternal plasma homocysteine, low-density lipoprotein, and triglyceride were significantly higher, while high-density lipoprotein was significantly lower in pregnancies with pre-eclampsia as compared with the uncomplicated pregnancy group (p<0.001 for all). Cord blood level of low-density lipoprotein and fibrinogen were best predicted by abdominal circumference of newborn, though maternal level of homocysteine was the most powerful independent predictor of cord homocysteine.

CONCLUSION

Intrauterine exposure to pre-eclampsia was associated with untoward effects on biochemical risk factor markers for cardiovascular disease. Our findings suggest that the cardiovascular risk of newborns of pre-eclamptic mothers may begin in utero.

摘要

背景

子宫内暴露于子痫前期的后代收缩压较高,青春期时更肥胖。我们推测,作为心血管疾病标志物的代谢变化可能会受到子宫内暴露于子痫前期的影响。

方法

采集了36例子宫内暴露于子痫前期的新生儿及其母亲的脐血样本,以及35例妊娠无并发症的新生儿及其母亲的脐血样本。测定了所有样本中脂质、同型半胱氨酸和纤维蛋白原的血清水平。

结果

与血压正常妊娠的胎儿相比,子宫内暴露于子痫前期的胎儿出生体重较低,腹围较小(分别为p<0.002;p<0.03),低密度脂蛋白、同型半胱氨酸和纤维蛋白原水平较高(分别为p<0.01;p<0.001;p<0.001)。母亲同型半胱氨酸浓度与新生儿同型半胱氨酸浓度之间存在显著相关性(r=0.539;p<0.001),母亲低密度脂蛋白与新生儿同型半胱氨酸之间也存在显著相关性(r=0.36;p<0.03)。新生儿腹围与脐血纤维蛋白原浓度(r=-0.52;p<0.001)和低密度脂蛋白浓度(r=-0.42;p<0.001)之间存在显著负相关。与无并发症妊娠组相比,子痫前期妊娠的母亲血浆同型半胱氨酸、低密度脂蛋白和甘油三酯显著升高,而高密度脂蛋白显著降低(所有p<0.001)。新生儿脐血低密度脂蛋白和纤维蛋白原水平最好通过新生儿腹围来预测,尽管母亲同型半胱氨酸水平是脐血同型半胱氨酸最有力的独立预测指标。

结论

子宫内暴露于子痫前期与心血管疾病生化危险因素标志物的不良影响有关。我们的研究结果表明,子痫前期母亲的新生儿心血管风险可能始于子宫内。

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