Key Laboratory of Environment and Health, Ministry of Education and Ministry of Environmental Protection, and State Key Laboratory of Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
Department of Epidemiology and Biostatistics, School of Public Health, Zhengzhou University, Zhengzhou, Henan, China.
Am J Hypertens. 2019 Apr 22;32(5):524-530. doi: 10.1093/ajh/hpz024.
Pregnancy hypertensive disorders have impaired neurodevelopment in offspring. We aimed to explore the association of normal range maternal blood pressure (BP) with child neurodevelopment, as well as the possible role of placental 11-beta-hydroxysteroid dehydrogenase type 2 (11β-HSD2) therein.
Among 1,008 mother-child pairs recruited in Wuhan, China, in 2013-2015, we measured maternal third-trimester BP (systolic BP (SBP) and diastolic BP (DBP)) and cord glucocorticoids (cortisol and cortisone), a marker reflecting placental 11β-HSD2 activity. We evaluated child neurodevelopment using the Bayley Scales of Infant Development (BSID) with obtaining the Mental and Psychomotor Development Index (MDI and PDI). Multiple regression and mediation analysis were performed to estimate the effect.
Each 5 mm Hg increase in maternal third-trimester SBP was associated with 1.54 points decrease in MDI (95% confidence interval (CI) = -2.60, -0.48) and 1.23 points decrease in PDI (95% CI = -2.14, -0.31); similar association was observed between DBP and BSID (adjusted β = -1.32; 95% CI = -2.53, -0.10 for MDI and -1.37; 95% CI = -2.42, -0.33 for PDI). Also, we found significant associations between cord cortisol/cortisone ratio and PDI (adjusted β = 2.95; 95% CI = 0.91, 4.99), as well as between maternal BP and cord cortisol/cortisone ratio (adjusted β = -0.03; 95% CI = -0.06, -0.01 for both SBP and DBP). Mediation analysis revealed that cord cortisol/cortisone ratio explained 6.29% of the association between SBP and PDI, and 6.85% between DBP and PDI.
Increased maternal normal range BP may affect child neurodevelopment. Furthermore, placental 11β-HSD2 activity might be involved in the process.
妊娠高血压疾病会损害后代的神经发育。我们旨在探讨正常范围内的母体血压（BP）与儿童神经发育的关系，以及胎盘 11-β-羟类固醇脱氢酶 2（11β-HSD2）在此过程中的可能作用。
在 2013-2015 年期间，我们在中国武汉招募了 1008 对母婴，测量了母亲孕晚期的血压（收缩压（SBP）和舒张压（DBP））和脐带皮质醇（皮质醇和可的松），这是反映胎盘 11β-HSD2 活性的标志物。我们使用贝利婴幼儿发展量表（BSID）评估儿童的神经发育，得出精神和运动发育指数（MDI 和 PDI）。采用多元回归和中介分析来估计影响。
母亲孕晚期 SBP 每增加 5mmHg，MDI 降低 1.54 分（95%置信区间（CI）=-2.60，-0.48），PDI 降低 1.23 分（95%CI=-2.14，-0.31）；DBP 与 BSID 也存在类似的相关性（调整β=-1.32；95%CI=-2.53，-0.10 用于 MDI 和-1.37；95%CI=-2.42，-0.33 用于 PDI）。此外，我们还发现脐带皮质醇/可的松比值与 PDI 之间存在显著关联（调整β=2.95；95%CI=0.91，4.99），以及母亲 BP 与脐带皮质醇/可的松比值之间存在显著关联（调整β=-0.03；95%CI=-0.06，-0.01 用于 SBP 和 DBP）。中介分析显示，脐带皮质醇/可的松比值解释了 SBP 与 PDI 之间关联的 6.29%，DBP 与 PDI 之间关联的 6.85%。
母体正常范围内的血压升高可能会影响儿童的神经发育。此外，胎盘 11β-HSD2 活性可能参与了这一过程。
