Optics and Imaging Center, Doris Duke Medical Research Institute, College of Health Sciences, University of Kwa-Zulu Natal, Durban, South Africa.
Department of Anatomy and Cell Biology, College of Health Sciences, Obafemi Awolowo University, Ife, Nigeria.
Curr Hypertens Rep. 2021 Mar 10;23(3):16. doi: 10.1007/s11906-021-01132-x.
Cardiovascular diseases (CVD), including pre-eclampsia (PE), remain the major cause of death and morbidity in women. This review elucidates the current knowledge, state of research and scientific information available on the post-event implications and complications of PE regarding maternal and foetal cardiovascular health. Does PE expose, predispose or aggravate a predilection to maternal and foetal CVD later in life?
Women with a history of PE are reported to have stiffer arteries and are more likely to develop cardiovascular problems with time, especially aortic stenosis and mitral regurgitation, which were not hitherto linked with hypertensive pregnancy. Foetal cells persistence in the mother long after pregnancy, now clearly established in the lungs of mice postpartum, is suggested to portend an overexpression of STOX1, which may potentiate later life CVD. Moreover, the conventional theories of in utero stress and developmental reprogramming may not adequately explain the risk of later life CVD predilection in offspring born to mothers with pre-eclampsia as recent data has shown that siblings of offspring born from pre-eclamptic pregnancies are also at higher risk of hypertension later in life, irrespective of whether subsequent pregnancies were pre-eclamptic or normotensive. The mechanism involved in adverse cardiovascular outcome in offspring of pre-eclamptic pregnancies is most likely an intricate interaction of foetal programming, environmental and genetic factors. In light of available evidence, the question of whether PE is just a pointer or predisposing factor to maternal development of CVDs in later life begs for answers to facilitate definitive clinical solutions and preventive approaches.
心血管疾病（CVD），包括子痫前期（PE），仍然是女性死亡和发病的主要原因。本综述阐明了关于 PE 对母婴心血管健康的后事件影响和并发症的现有知识、研究现状和科学信息。PE 是否会暴露、易患或加重以后生活中母婴 CVD 的倾向？
有 PE 病史的女性报告称动脉僵硬程度更高，随着时间的推移更容易出现心血管问题，尤其是主动脉瓣狭窄和二尖瓣反流，这些问题以前与妊娠高血压无关。胎儿细胞在母亲体内的长期存在，现在在产后小鼠的肺部中得到了明确证实，这表明 STOX1 的过度表达可能预示着以后生活中的 CVD 风险增加。此外，传统的宫内应激和发育重编程理论可能不能充分解释子痫前期母亲所生孩子以后生活中 CVD 倾向的风险，因为最近的数据表明，即使以后的妊娠是子痫前期或正常血压，子痫前期所生孩子的兄弟姐妹以后也有更高的高血压风险。PE 妊娠后代不良心血管结局的发生机制很可能是胎儿编程、环境和遗传因素的复杂相互作用。鉴于现有证据，PE 是否只是以后生活中 CVD 发展的一个指标或易患因素，需要答案来促进明确的临床解决方案和预防方法。
