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子痫前期妊娠患者后代的心血管危险因素:系统评价和荟萃分析。

Cardiovascular Risk Factors in Offspring of Preeclamptic Pregnancies-Systematic Review and Meta-Analysis.

机构信息

Adelaide Medical School and The Robinson Research Institute, The University of Adelaide, Adelaide, Australia.

Adelaide Medical School and The Robinson Research Institute, The University of Adelaide, Adelaide, Australia.

出版信息

J Pediatr. 2019 May;208:104-113.e6. doi: 10.1016/j.jpeds.2018.12.008. Epub 2019 Mar 12.

Abstract

OBJECTIVE

To evaluate evidence for increased cardiovascular disease (CVD) risk factors in children exposed to preeclampsia in utero.

STUDY DESIGN

PubMed, the Cumulative Index to Nursing and Allied Health Literature, the Cochrane Library, and EMBASE electronic databases were searched with an end of search date of June 4, 2018. Prospective and retrospective studies that compared CVD risk factors in those exposed to preeclampsia in utero with controls were eligible. Information was extracted on established CVD risk factors, including blood pressure, lipid profile, blood glucose, fasting insulin, body mass index, and endothelial/microvascular function.

RESULTS

Thirty-six studies provided cumulated data on 53 029 individuals. In utero exposure to preeclampsia was associated with 5.17 mm Hg (95% CI 1.60-8.73) greater mean systolic, 4.06 mm Hg (95% CI 0.67-7.44) greater mean diastolic blood pressure, and 0.36 kg/m (95% CI 0.04-0.68) greater mean body mass index during childhood or young adulthood. No significant association was seen between exposure to preeclampsia in utero and other CVD risk factors.

CONCLUSIONS

Offspring of preeclamptic pregnancies demonstrate risk factors for CVD during childhood and young adult life. Early blood pressure screening of children born after preeclamptic pregnancies may identify those that require interventions or preventive strategies to reduce later life CVD risk.

摘要

目的

评估宫内暴露于子痫前期的儿童心血管疾病(CVD)风险因素增加的证据。

研究设计

检索了 PubMed、 Cumulative Index to Nursing and Allied Health Literature、Cochrane Library 和 EMBASE 电子数据库,检索日期截至 2018 年 6 月 4 日。符合条件的研究为前瞻性和回顾性研究,比较了宫内暴露于子痫前期与对照组的 CVD 风险因素。提取了已建立的 CVD 风险因素的信息,包括血压、血脂谱、血糖、空腹胰岛素、体重指数和内皮/微血管功能。

结果

36 项研究提供了 53029 个人的累积数据。宫内暴露于子痫前期与收缩压平均增加 5.17mmHg(95%CI 1.60-8.73)、舒张压平均增加 4.06mmHg(95%CI 0.67-7.44)和儿童或青年期体重指数平均增加 0.36kg/m²(95%CI 0.04-0.68)相关。宫内暴露于子痫前期与其他 CVD 风险因素之间无显著相关性。

结论

子痫前期妊娠的后代在儿童和青年时期表现出 CVD 的风险因素。对子痫前期后出生的儿童进行早期血压筛查可能会发现需要干预或预防策略以降低以后的 CVD 风险。

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