Herzog Emilie M, Eggink Alex J, Reijnierse Anniek, Kerkhof Martina A M, de Krijger Ronald R, Roks Anton J M, Reiss Irwin K M, Nigg Alex L, Eilers Paul H C, Steegers Eric A P, Steegers-Theunissen Régine P M
Department of Obstetrics and Gynaecology, Erasmus MC, University Medical Centre Rotterdam, Postbus 2040, 3000 CA Rotterdam, The Netherlands.
Department of Pathology, Erasmus MC, University Medical Centre Rotterdam, Postbus 2040, 3000 CA Rotterdam, The Netherlands; Department of Pathology, Reinier de Graaf Hospital, Reinier de Graafweg 5, 2625 AD Delft, The Netherlands.
Placenta. 2017 Jan;49:72-79. doi: 10.1016/j.placenta.2016.11.014. Epub 2016 Nov 27.
Offspring exposed to preeclampsia (PE) show an increased risk of cardiovascular disease in adulthood. We hypothesize that this is mediated by a disturbed vascular development of the placenta, umbilical cord and fetus. Therefore, we investigated associations between early-onset PE (EOPE), late-onset PE (LOPE) and features of placental and newborn vascular health.
We performed a nested case-control study in The Rotterdam Periconceptional Cohort, including 30 PE pregnancies (15 EOPE, 15 LOPE) and 218 control pregnancies (164 uncomplicated controls, 54 complicated controls including 28 fetal growth restriction, 26 preterm birth) and assessed macroscopic and histomorphometric outcomes of the placenta and umbilical cord.
A significant association was observed between PE and a smaller umbilical vein area and wall thickness, independent of gestational age and birth weight. In EOPE we observed significant associations with a lower weight, length and width of the placenta, length of the umbilical cord, and thickness and wall area of the umbilical vein and artery. These associations attenuated after gestational age and birth weight adjustment. In LOPE a significant association with a larger placental width and smaller umbilical vein wall thickness was shown, independent of gestational age and birth weight.
Our study suggests that PE is associated with a smaller umbilical cord vein area and wall thickness, independent of gestational age and birth weight, which may serve as a proxy of disturbed cardiovascular development in the newborn. Follow-up studies are needed to ultimately predict and lower the risk of cardiovascular disease in offspring exposed to PE.
暴露于先兆子痫（PE）的后代在成年后患心血管疾病的风险增加。我们假设这是由胎盘、脐带和胎儿的血管发育紊乱介导的。因此，我们研究了早发型PE（EOPE）、晚发型PE（LOPE）与胎盘和新生儿血管健康特征之间的关联。
我们在鹿特丹围孕期队列中进行了一项巢式病例对照研究，包括30例PE妊娠（15例EOPE，15例LOPE）和218例对照妊娠（164例无并发症对照，54例复杂对照，包括28例胎儿生长受限、26例早产），并评估了胎盘和脐带的宏观和组织形态学结果。
观察到PE与较小的脐静脉面积和壁厚之间存在显著关联，且不受孕周和出生体重的影响。在EOPE中，我们观察到与胎盘的较低重量、长度和宽度、脐带长度以及脐静脉和动脉的厚度和壁面积存在显著关联。在调整孕周和出生体重后，这些关联减弱。在LOPE中，显示出与较大的胎盘宽度和较小的脐静脉壁厚存在显著关联，且不受孕周和出生体重的影响。
我们的研究表明，PE与较小的脐带静脉面积和壁厚有关，且不受孕周和出生体重的影响，这可能是新生儿心血管发育紊乱的一个指标。需要进行后续研究，以最终预测并降低暴露于PE的后代患心血管疾病的风险。
