Clinical Research Unit, Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira, Instituto Fernandes Figueira, Fundação Oswaldo Cruz, Av. Rui Barbosa, 716, Flamengo, Rio de Janeiro, RJ, 22250-020, Brazil.
Department of Obstetrics, Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil.
Eur J Pediatr. 2020 Aug;179(8):1239-1246. doi: 10.1007/s00431-020-03586-8. Epub 2020 Feb 15.
Maternal hypertension may alter physiological parameters, dysregulating the release of hormones such as adipokines, thus influencing the fetal growth course. This study investigated whether hypertensive disorders of pregnancy alter cord blood adipokine levels and correlate these with anthropometric parameters in preterm infants. This is a prospective cohort study with pregnant women < 37-week gestation with and without hypertension and their offspring. Cord blood leptin, adiponectin, and ghrelin were analyzed by LUMINEX®. These adipokines were compared between the groups exposed or not to gestational hypertension using non-parametric statistical tests. The hypertensive pregnancies had significantly higher cord blood leptin (1.00 (IQR 0.67-1.20 ng/mL)) and adiponectin (18.52 (IQR 17.52-25.13 μg/mL)) levels than those without hypertension (0.07 (IQR 0.06-0.08 ng/mL) and 8.13 (IQR 6.50-8.68 μg/mL), respectively, p < 0.0001). The adipokine levels were higher in AGA and SGA infants in the exposed group for both moderate and late preterm. SGA had significantly higher ghrelin levels than the AGA infants. Ghrelin levels were negatively correlated with birth weight (r = - 0.613, p < 0.001), birth length (r = - 0.510, p < 0.001), head circumference (- 0.346, p < 0.002), and gestational age (r = - 0.612, p < 0.001).Conclusions: Our findings demonstrate an increase in adipokine levels in the cord blood of preterm newborn infants exposed to maternal hypertension. What is Known: • Clinical evidence suggests that concentration of the serum adipokines may be affected by risk of hypertension in both adults and pregnant women. • Maternal profile as hypertension alters intrauterine environment and could affect the function of fetal metabolism, impairing fetal growth. What is New: • Gestational hypertension modifies the adipokine profile, with higher rates already present at birth in cord blood samples. • Within the hypertensive group and stratifying for gestation age, ghrelin concentrations were higher in SGA newborns, both in the moderate and late preterm, compared with AGA newborns.
母体高血压可能会改变生理参数，扰乱脂肪因子等激素的释放，从而影响胎儿的生长过程。本研究旨在探讨妊娠高血压疾病是否会改变早产儿脐带血中脂肪因子的水平，并将这些水平与早产儿的人体测量参数相关联。这是一项前瞻性队列研究，纳入了妊娠不足 37 周的孕妇，无论是否患有高血压，及其新生儿。采用 LUMINEX®法检测脐带血瘦素、脂联素和胃饥饿素。使用非参数统计检验比较两组孕妇的脐带血脂肪因子。患有高血压妊娠的孕妇其脐带血瘦素（1.00（IQR 0.67-1.20ng/ml））和脂联素（18.52（IQR 17.52-25.13μg/ml））水平显著高于未患高血压的孕妇（0.07（IQR 0.06-0.08ng/ml）和 8.13（IQR 6.50-8.68μg/ml），均 P<0.0001）。暴露组中，无论中早产儿还是晚早产儿，AGA 和 SGA 婴儿的脂肪因子水平均较高。与 AGA 婴儿相比，SGA 婴儿的胃饥饿素水平显著升高。胃饥饿素水平与出生体重（r=-0.613，P<0.001）、出生长度（r=-0.510，P<0.001）、头围（r=-0.346，P<0.002）和胎龄（r=-0.612，P<0.001）呈负相关。结论：我们的研究结果表明，暴露于母体高血压的早产儿脐带血中脂肪因子水平升高。已知情况：•临床证据表明，血清脂肪因子的浓度可能会受到成人和孕妇高血压风险的影响。•母体高血压改变了宫内环境，可能影响胎儿代谢功能，从而损害胎儿生长。新发现：•妊娠高血压改变了脂肪因子谱，在脐带血样本中，即使在出生时就已经存在较高的水平。•在高血压组中，并按胎龄分层，与 AGA 新生儿相比，无论是中早产儿还是晚早产儿，SGA 新生儿的 ghrelin 浓度均较高。
