Vascular Surgery Research Laboratories, Division of Vascular and Endovascular Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA.
Vascular Surgery Research Laboratories, Division of Vascular and Endovascular Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA.
Biochem Pharmacol. 2020 Dec;182:114247. doi: 10.1016/j.bcp.2020.114247. Epub 2020 Sep 25.
Preeclampsia (PE) is a complication of pregnancy characterized by hypertension (HTN-Preg), and often proteinuria. If not managed promptly, PE could lead to eclampsia and seizures. PE could also lead to intrauterine growth restriction (IUGR) and prematurity at birth. Although PE is a major cause of maternal and fetal morbidity and mortality, the underlying mechanisms are unclear. Also, there is a wide variability in the incidence of PE, ranging between 2 and 8% of pregnancies in the Eastern, Western and Developing world, suggesting regional differences in the risk factors and predictors of the pregnancy-related disorder. Several demographic, genetic, dietary and environmental factors, as well as maternal circulating biomarkers have been associated with PE. Demographic factors such as maternal race and ethnicity could play a role in PE. Specific genetic polymorphisms have been identified in PE. Maternal age, parity, education and socioeconomic status could be involved in PE. Dietary fat, protein, calcium and vitamins, body weight, and environmental factors including climate changes and air pollutants could also play a role in PE. Several circulating cytoactive factors including anti-angiogenic factors and cytokines have also been associated with PE. Traditional midwifery care is a common practice in local maternity care units, while advanced perinatal care and new diagnostic tools such as uterine artery Doppler velocimetry have been useful in predicting early PE in major medical centers. These PE risk factors, early predictors and diagnostic tools vary vastly in different regions of the Eastern, Western and Developing world. Further understanding of the differences in the demographic, genetic, dietary and environmental factors among pregnant women in different world regions should help in designing a region-specific cluster of risk factors and predictors of PE, and in turn provide better guidance for region-specific tools for early detection and management of PE.
子痫前期 (PE) 是一种妊娠并发症，其特征为高血压 (HTN-Preg)，常伴有蛋白尿。如果不能及时处理，PE 可能导致子痫和抽搐。PE 还可能导致宫内生长受限 (IUGR) 和早产。尽管 PE 是孕产妇和胎儿发病率和死亡率的主要原因，但发病机制尚不清楚。此外，PE 的发病率差异很大，在东部、西部和发展中国家的妊娠中分别为 2%至 8%，这表明与妊娠相关的疾病的危险因素和预测因素存在区域性差异。一些人口统计学、遗传、饮食和环境因素以及母体循环生物标志物与 PE 相关。人口统计学因素，如孕产妇种族和民族，可能在 PE 中发挥作用。PE 中已经确定了特定的遗传多态性。孕产妇年龄、产次、教育程度和社会经济地位可能与 PE 有关。饮食中的脂肪、蛋白质、钙和维生素、体重以及气候变化和空气污染物等环境因素也可能在 PE 中发挥作用。一些循环细胞活性因子，包括抗血管生成因子和细胞因子，也与 PE 相关。传统的助产护理是当地产科护理单位的常见做法，而先进的围产期护理和新的诊断工具，如子宫动脉多普勒血流速度，已在主要医疗中心用于预测早期 PE。这些 PE 的危险因素、早期预测因子和诊断工具在东部、西部和发展中国家的不同地区差异很大。进一步了解不同世界地区孕妇在人口统计学、遗传、饮食和环境因素方面的差异，有助于设计针对特定地区的 PE 危险因素和预测因子群，并为特定地区的早期检测和管理 PE 提供更好的指导。
