The Generation R Study Group, Erasmus University Medical Center, Rotterdam, the Netherlands; Department of Pediatrics, Sophia Children's Hospital, Erasmus University Medical Center, Rotterdam, the Netherlands.
The Generation R Study Group, Erasmus University Medical Center, Rotterdam, the Netherlands; Department of Pediatrics, Sophia Children's Hospital, Erasmus University Medical Center, Rotterdam, the Netherlands.
Atherosclerosis. 2021 Dec;338:46-54. doi: 10.1016/j.atherosclerosis.2021.11.005. Epub 2021 Nov 6.
Reduced maternal placental growth factor (PlGF) and higher soluble fms-like tyrosine kinase (sFlt-1) concentrations in pregnancy may have persistent effects on offspring vasculature. We hypothesized that suboptimal maternal angiogenic factors in pregnancy may adversely affect fetal vascular development, leading to an increased risk of adverse atheriosclerotic adaptations and higher blood pressure in offspring.
In a population-based prospective cohort among 4565 women and their offspring, we examined the associations of maternal serum PlGF and sFlt-1 concentrations in the first half of pregnancy with offspring vascular development. We measured childhood blood pressure and obtained childhood carotid intima media thickness and carotid distensibility through ultrasonography at 9 years.
After adjustment for maternal sociodemographic and lifestyle characteristics, no associations were present of maternal first and second trimester angiogenic factors with childhood blood pressure, carotid intima media thickness (IMT) or distensibility in the total population. In preterm born children only, higher maternal second trimester PlGF concentrations, but not sFlt-1 concentrations, were associated with a lower childhood diastolic blood pressure (difference: -0.16 SDS (95% CI -0.30, -0.03) per SDS increase in maternal second trimester PlGF concentration). No associations among children born small-for-gestational age were present.
In a low-risk population, maternal angiogenic factors in the first half of pregnancy are not associated with childhood blood pressure, carotid IMT or carotid distensibility after considering maternal socio-demographic and lifestyle factors. Only in children born preterm, lower maternal second trimester PlGF concentrations are associated with higher childhood diastolic blood pressure, but not with other vascular outcomes.
妊娠期间母体胎盘生长因子（PlGF）水平降低和可溶性 fms 样酪氨酸激酶（sFlt-1）水平升高可能对后代的血管系统产生持久影响。我们假设妊娠期间母体血管生成因子不足可能会对胎儿血管发育产生不利影响，导致后代发生不良的动脉粥样硬化适应和血压升高的风险增加。
在一项基于人群的前瞻性队列研究中，我们纳入了 4565 名女性及其后代，研究了妊娠前半期母体血清 PlGF 和 sFlt-1 浓度与后代血管发育的相关性。我们在儿童 9 岁时测量了血压，并通过超声检查获得了颈动脉内膜中层厚度和颈动脉可扩张性。
在调整了母体社会人口统计学和生活方式特征后，母体妊娠前半期和妊娠后半期的血管生成因子与儿童血压、颈动脉内膜中层厚度（IMT）或总人群的颈动脉可扩张性均无相关性。仅在早产儿中，较高的母体妊娠中期 PlGF 浓度与儿童舒张压降低相关（差异：-0.16 SDS[母体妊娠中期 PlGF 浓度每增加 1 个标准差的差异，95%CI -0.30，-0.03]）。在小于胎龄儿中未发现相关性。
在低风险人群中，妊娠前半期的母体血管生成因子与考虑了母体社会人口统计学和生活方式因素后的儿童血压、颈动脉 IMT 或颈动脉可扩张性无关。仅在早产儿中，较低的母体妊娠中期 PlGF 浓度与较高的儿童舒张压相关，而与其他血管结局无关。
