Alsnes Ingvild V, Janszky Imre, Forman Michele R, Vatten Lars J, Økland Inger
Department of Obstetrics and Gynecology, Stavanger University Hospital, Stavanger, Norway.
Department of Public Health, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway.
Am J Obstet Gynecol. 2014 Dec;211(6):657.e1-7. doi: 10.1016/j.ajog.2014.06.026. Epub 2014 Jun 17.
Women with a history of preeclampsia are at increased lifetime risk for cardiovascular disease. Their offspring may carry similar risks. The aim was to study cardiovascular and metabolic risk factors 11 years after the delivery among women who were diagnosed with mild, moderate, or severe preeclampsia, and their offspring, compared with women without preeclampsia and their offspring.
In a follow-up 11 years after a nested case-control study at birth, we studied 611 mother-offspring dyads, including 228 dyads with preeclampsia in the index pregnancy and 383 dyads without preeclampsia. Cardiovascular and metabolic risk profiles were assessed by serum lipids (total cholesterol, high-density lipoprotein [HDL] cholesterol, non-HDL cholesterol), insulin-related factors (glucose, insulin, and homeostasis assessment model for insulin resistance) and blood pressure in mothers and children.
Among mothers with mild or moderate preeclampsia, levels of glucose, insulin, and homeostasis assessment model for insulin resistance were higher than in the nonpreeclampsia group and also higher compared with mothers with severe preeclampsia (all P < .05). HDL cholesterol was lower in mothers with mild or moderate preeclampsia (all P < .05), but other lipids did not substantially differ between the groups. Body mass index and blood pressure (systolic and diastolic) were also higher in the mild and moderate preeclampsia group compared with mothers without preeclampsia (all P < .05). Among the offspring, we found no clear differences in any blood analytes between the groups.
Women with a previous diagnosis of mild or moderate, but not severe, preeclampsia may have an adverse metabolic and cardiovascular risk profile 11 years after the delivery.
有子痫前期病史的女性一生患心血管疾病的风险增加。她们的后代可能也有类似风险。本研究旨在比较患有轻度、中度或重度子痫前期的女性及其后代与未患子痫前期的女性及其后代在分娩11年后的心血管和代谢危险因素。
在一项出生时的巢式病例对照研究之后11年的随访中，我们研究了611对母婴二元组，其中包括228对在本次妊娠中患有子痫前期的二元组和383对未患子痫前期的二元组。通过血清脂质（总胆固醇、高密度脂蛋白[HDL]胆固醇、非HDL胆固醇）、胰岛素相关因子（葡萄糖、胰岛素以及胰岛素抵抗的稳态评估模型）和母婴的血压来评估心血管和代谢风险状况。
在患有轻度或中度子痫前期的母亲中，葡萄糖、胰岛素以及胰岛素抵抗的稳态评估模型水平高于未患子痫前期组，并且也高于患有重度子痫前期的母亲（所有P <.05）。轻度或中度子痫前期母亲的HDL胆固醇较低（所有P <.05），但其他脂质在各组之间没有显著差异。与未患子痫前期的母亲相比，轻度和中度子痫前期组的体重指数和血压（收缩压和舒张压）也更高（所有P <.05）。在后代中，我们发现各组之间在任何血液分析物上均无明显差异。
既往诊断为轻度或中度而非重度子痫前期的女性在分娩11年后可能具有不良的代谢和心血管风险状况。
