Hakim Julie, Senterman Mary K, Hakim Antoine M
Department of Obstetrics and Gynecology, The Ottawa Hospital and the University of Ottawa, General Campus, 501 Smyth Road, Ottawa, ON, Canada K1H 8L6.
Int J Pediatr. 2013;2013:953150. doi: 10.1155/2013/953150. Epub 2013 Apr 16.
This paper reviews the literature pertaining to the impact of preeclampsia not only on the mother but particularly on the children. The review points to the higher blood pressure in children born to preeclamptic mothers compared to controls, their increased tendency to suffer strokes, the reduction in their cognitive ability, and their vulnerability to depression. Mechanisms that may induce these changes are emphasized, particularly the placental vascular insufficiency and the resulting hypoxic and proinflammatory environments in which the fetus develops. The hypothesis proposed is that these changes in the fetal-placental environment result in epigenetic programming of the child towards a higher propensity for vascular disease. The review's main recommendation is that, within ethical boundaries, the medical records of individuals born to preeclamptic mothers should clearly indicate this event and should be made available to the affected individuals so that preventive measures against vascular complications and lifestyle changes that may mitigate the latter can be instituted.
本文回顾了有关子痫前期不仅对母亲而且特别是对子女影响的文献。该综述指出,与对照组相比,子痫前期母亲所生子女的血压更高,患中风的倾向增加,认知能力下降,且易患抑郁症。文中强调了可能导致这些变化的机制,特别是胎盘血管功能不全以及胎儿发育所处的由此产生的缺氧和促炎环境。所提出的假设是,胎儿 - 胎盘环境中的这些变化导致儿童表观遗传编程,使其患血管疾病的倾向更高。该综述的主要建议是,在道德界限内,子痫前期母亲所生个体的病历应明确注明这一情况,并应向受影响个体提供,以便能够采取预防血管并发症的措施以及可能减轻其影响的生活方式改变。