心血管危险因素从母亲传给孩子。
Cardiovascular Risk Factors Track From Mother to Child.
机构信息
1 Department of Obstetrics and Gynecology Erasmus Medical Center Rotterdam The Netherlands.
2 Department of General Medicine Erasmus Medical Center Rotterdam The Netherlands.
出版信息
J Am Heart Assoc. 2018 Oct 2;7(19):e009536. doi: 10.1161/JAHA.118.009536.
Background Cardiovascular risk factors can track from mother to child by several pathways: pregnancy complications, genetic inheritance, and shared environmental risk factors after pregnancy. The degree of tracking, and to which extent this is influenced by these pathways, is unknown. We hypothesized that cardiovascular risk factors track from mother to child regardless of pregnancy complications and environmental risk factors. We determined the degree of tracking between maternal and offspring micro- and macrovascular cardiovascular risk factors after pregnancy and the extent to which this is influenced by pregnancy complications and shared environmental risk factors. Methods and Results We included 5624 mother-offspring pairs from The Generation R Study, an ongoing prospective, population-based birth cohort. Information on pregnancy complications (preeclampsia, small for gestational age, and preterm birth) was obtained through hospital charts. Mother-offspring associations were assessed 6 years after pregnancy (central retinal arteriolar and venular calibers, body mass index, blood pressure, left atrial diameter, aortic root diameter, left ventricular mass, fractional shortening, and pulse wave velocity) and 9 years after pregnancy (body mass index and blood pressure). We observed that worse cardiovascular parameters in mothers were associated with worse cardiovascular parameters in their offspring 6 and 9 years after pregnancy ( P<0.001). Results were similar when mother-offspring pairs with a previous pregnancy complication were excluded. Conclusions Six and 9 years after pregnancy, an adverse cardiovascular profile in mothers is strongly associated with an adverse cardiovascular profile in their offspring. Results were not attenuated by environmental exposures or a previous pregnancy complication. This supports the hypothesis that cardiovascular risk factors (micro- and macrovascular) track from mother to child, regardless of the course of pregnancy.
背景
心血管危险因素可通过多种途径从母亲传递给孩子:妊娠并发症、遗传、妊娠后共同的环境危险因素。这些途径的跟踪程度以及受其影响的程度尚不清楚。我们假设,无论是否存在妊娠并发症和环境危险因素,心血管危险因素都会从母亲传递给孩子。我们确定了妊娠后母亲和后代的微血管和大血管心血管危险因素之间的跟踪程度,以及这些因素受妊娠并发症和共同环境危险因素影响的程度。
方法和结果
我们纳入了来自“世代研究”的 5624 对母婴对,这是一项正在进行的、基于人群的前瞻性出生队列研究。通过医院病历获取妊娠并发症(子痫前期、胎儿生长受限和早产)的信息。在妊娠后 6 年(视网膜中央动脉和静脉的直径、体重指数、血压、左心房直径、主动脉根部直径、左心室质量、缩短分数和脉搏波速度)和 9 年后(体重指数和血压)评估母婴相关性。我们发现,母亲的心血管参数较差与后代的心血管参数较差在妊娠后 6 年和 9 年都有显著相关性(P<0.001)。当排除有既往妊娠并发症的母婴对时,结果仍然相似。
结论
在妊娠后 6 年和 9 年,母亲不良的心血管状况与后代不良的心血管状况密切相关。结果不受环境暴露或既往妊娠并发症的影响。这支持了心血管危险因素(微血管和大血管)从母亲传递给孩子的假设,而与妊娠过程无关。