Department of Psychiatry, University of Iowa Carver College of Medicine, Department of Psychiatry, Iowa City, IA, USA.
University of Iowa Carver College of Medicine, Department of Obstetrics and Gynecology, Iowa City, IA, USA.
Trends Neurosci. 2020 Apr;43(4):253-268. doi: 10.1016/j.tins.2020.02.003. Epub 2020 Mar 6.
Preeclampsia is a dangerous hypertensive disorder of pregnancy with known links to negative child health outcomes. Here, we review epidemiological and basic neuroscience work from the past several decades linking prenatal preeclampsia to altered neurodevelopment. This work demonstrates increased rates of neuropsychiatric disorders [e.g., increased autism spectrum disorder, attention deficit hyperactivity disorder (ADHD)] in children of preeclamptic pregnancies, as well as increased rates of cognitive impairments [e.g., decreased intelligence quotient (IQ), academic performance] and neurological disease (e.g., stroke and epilepsy). We also review findings from multiple animal models of preeclampsia. Manipulation of key clinical preeclampsia processes in these models (e.g., placental hypoxia, immune dysfunction, angiogenesis, oxidative stress) causes various disruptions in offspring, including ones in white matter/glia, glucocorticoid receptors, neuroimmune outcomes, cerebrovascular structure, and cognition/behavior. This animal work implicates potentially high-yield targets that may be leveraged in the future for clinical application.
子痫前期是一种危险的妊娠高血压疾病,已知与儿童健康不良结局有关。在这里,我们回顾了过去几十年中与产前子痫前期相关的流行病学和基础神经科学研究,这些研究表明,子痫前期孕妇所生孩子的神经精神疾病(如自闭症谱系障碍、注意缺陷多动障碍(ADHD))的发生率增加,以及认知障碍(如智商降低、学业成绩下降)和神经系统疾病(如中风和癫痫)的发生率增加。我们还回顾了多种子痫前期动物模型的研究结果。在这些模型中对关键的临床子痫前期过程(如胎盘缺氧、免疫功能障碍、血管生成、氧化应激)的操作会导致后代出现各种异常,包括白质/胶质、糖皮质激素受体、神经免疫结果、脑血管结构和认知/行为的异常。这些动物研究表明,可能存在高收益的靶点,未来可能会被应用于临床。