Néphrologie Et Dialyse, Centre Hospitalier Le Mans, 194 Avenue Rubillard, 72000, Le Mans, France.
Azienda Ospedaliera Brotzu, Cagliari, Italy.
Pediatr Nephrol. 2022 Aug;37(8):1733-1745. doi: 10.1007/s00467-021-05235-0. Epub 2021 Nov 4.
Preeclampsia is a protean syndrome causing a kidney disease characterised by hypertension and proteinuria, usually considered transitory and reversible after delivery. Its prevalence ranges from 3-5 to 10% if all the related disorders are considered. This narrative review, on behalf of the Kidney and Pregnancy Study Group of the Italian Society of Nephrology, focuses on three reasons why preeclampsia should concern paediatric nephrologists and how they can play an important role in its prevention, as well as in the prevention of future kidney and cardiovascular diseases. Firstly, all diseases of the kidney and urinary tract diagnosed in paediatric age are associated with a higher risk of adverse pregnancy-related outcomes, including preeclampsia. Secondly, babies with low birth weights (small for gestational age, born preterm, or both) have an increased risk of developing the full panoply of metabolic diseases (obesity, hypertension, early-onset cardiopathy and chronic kidney disease) and girls are at higher risk of developing preeclampsia when pregnant. The risk may be particularly high in cases of maternal preeclampsia, highlighting a familial aggregation of this condition. Thirdly, pregnant teenagers have a higher risk of developing preeclampsia and the hypertensive disorders of pregnancy, and should be followed up as high risk pregnancies. In summary, preeclampsia has come to be seen as a window on the future health of both mother and baby. Identification of subjects at risk, early counselling and careful follow-up can contribute to reducing the high morbidity linked with this disorder.
子痫前期是一种多形性综合征，可导致肾脏疾病，其特征为高血压和蛋白尿，通常认为在分娩后是短暂和可逆的。如果考虑所有相关疾病，其患病率在 3-5%到 10%之间。意大利肾脏病学会肾脏病与妊娠研究组的这份叙述性综述重点关注了子痫前期为何应引起儿科肾病学家关注的三个原因，以及他们如何在预防子痫前期以及预防未来的肾脏和心血管疾病方面发挥重要作用。首先，儿科时期诊断出的所有肾脏和泌尿道疾病都与妊娠相关不良结局（包括子痫前期）的风险增加有关。其次，出生体重低（小于胎龄儿、早产或两者兼有）的婴儿发生一系列代谢疾病（肥胖、高血压、早发心脏病和慢性肾脏病）的风险增加，且女孩在怀孕时发生子痫前期的风险更高。如果母亲患有子痫前期，风险可能特别高，这突出了这种疾病的家族聚集性。第三，青少年孕妇发生子痫前期和妊娠高血压疾病的风险更高，应作为高危妊娠进行随访。总之，子痫前期已被视为母婴未来健康的窗口。识别高危人群、早期咨询和仔细随访有助于降低与这种疾病相关的高发病率。
