Hromadnikova Ilona, Kotlabova Katerina, Dvorakova Lenka, Krofta Ladislav
Department of Molecular Biology and Cell Pathology, Third Faculty of Medicine, Charles University, 10000 Prague, Czech Republic.
Institute for the Care of the Mother and Child, Third Faculty of Medicine, Charles University, 14700 Prague, Czech Republic.
J Clin Med. 2019 Apr 20;8(4):544. doi: 10.3390/jcm8040544.
The aim of the present study was to assess the long-term outcomes of women 3-to-11 years postpartum in relation to the previous occurrence of pregnancy-related complications such as gestational hypertension (GH), preeclampsia (PE) and fetal growth restriction (FGR). Body mass index (BMI), waist circumference values, the average values of systolic (SBP) and diastolic (DBP) blood pressures and heart rate, total serum cholesterol levels, serum HDL (high-density lipoprotein) cholesterol levels, serum LDL (low-density lipoprotein) cholesterol levels, serum triglycerides levels, serum lipoprotein A levels, serum CRP (C-reactive protein) levels, plasma homocysteine levels, serum uric acid levels, individual and relative risks of having a heart attack or stroke over the next ten years were compared between groups (50 GH, 102 PE, 34 FGR and 90 normal pregnancies) and correlated with the severity of the disease with regard to clinical signs (25 PE without severe features, 77 PE with severe features), and delivery date (36 early PE, 66 late PE). The adjustment for potential covariates was made, where appropriate. At 3-11 years follow-up women with a history of GH, PE regardless of the severity of the disease and the delivery date, PE without severe features, PE with severe features, early PE, and late PE had higher BMI, waist circumferences, SBP, DBP, and predicted 10-year cardiovascular event risk when compared with women with a history of normotensive term pregnancy. In addition, increased serum levels of uric acid were found in patients previously affected with GH, PE regardless of the severity of the disease and the delivery date, PE with severe features, early PE, and late PE. Higher serum levels of lipoprotein A were found in patients previously affected with early PE. The receiver operating characteristic (ROC) curve analyses were able to identify a substantial proportion of women previously affected with GH or PE with a predisposition to later onset of cardiovascular diseases. Women with a history of GH and PE represent a risky group of patients that may benefit from implementation of early primary prevention strategies.
本研究的目的是评估产后3至11年的女性与先前发生的妊娠相关并发症（如妊娠期高血压（GH）、子痫前期（PE）和胎儿生长受限（FGR））相关的长期结局。比较了各组（50例GH、102例PE、34例FGR和90例正常妊娠）的体重指数（BMI）、腰围值、收缩压（SBP）和舒张压（DBP）平均值以及心率、总血清胆固醇水平、血清高密度脂蛋白（HDL）胆固醇水平、血清低密度脂蛋白（LDL）胆固醇水平、血清甘油三酯水平、血清脂蛋白A水平、血清C反应蛋白（CRP）水平、血浆同型半胱氨酸水平、血清尿酸水平，以及未来十年发生心脏病发作或中风的个体和相对风险，并将其与疾病严重程度（根据临床体征（25例无严重特征的PE、77例有严重特征的PE））和分娩日期（36例早发型PE、66例晚发型PE）相关联。在适当情况下对潜在协变量进行了调整。在3至11年的随访中，与有血压正常足月妊娠史的女性相比，有GH、PE病史（无论疾病严重程度和分娩日期）、无严重特征的PE、有严重特征的PE、早发型PE和晚发型PE的女性具有更高的BMI、腰围、SBP、DBP以及预测的10年心血管事件风险。此外，在先前患有GH、PE（无论疾病严重程度和分娩日期）、有严重特征的PE、早发型PE和晚发型PE的患者中发现血清尿酸水平升高。在先前患有早发型PE的患者中发现血清脂蛋白A水平较高。受试者工作特征（ROC）曲线分析能够识别出很大一部分先前患有GH或PE且易患后期心血管疾病的女性。有GH和PE病史的女性是一组高危患者，可能会从早期一级预防策略的实施中受益。
