Department of Critical Care Medicine, Fujian Provincial Hospital South Branch, The Shengli Clinical Medical College of Fujian Medical University, Fuzhou, Fujian Province, China.
Department of Respirology, Peking University People's Hospital, Beijing, China.
Sleep Breath. 2022 Dec;26(4):1661-1669. doi: 10.1007/s11325-021-02529-3. Epub 2021 Nov 29.
Pregnant women are predisposed to obstructive sleep apnea (OSA). Based on the fact that OSA is an independent risk factor for hypertension among the general population, we hypothesized that chronic intermittent hypoxia (CIH), as a feature of OSA, may lead to preeclampsia.
Pregnant and non-pregnant C57BL/6 J mice were exposed to two conditions of chronic intermittent hypoxia: CIH1 (21-5% O alternations), CIH2 (21-10% O alternations), and room air until day 19.
In non-pregnant mice, compared with their respective baseline values, systolic blood pressure (SBP) started to rise from day 14 in the CIH1 group, and SBP rose until day 19 in the CIH2 group. Compared with the pregnant mice exposed to room air, pregnant mice exposed to CIH1 maintained elevated SBP from day 14, accompanied by proteinuria, fetal and placental growth restriction, and a reduction in the number of fetuses. An imbalance between proangiogenic and antiangiogenic factors and impairment of vascular remodeling existed in the placenta of pregnant mice exposed to CIH1. Maternal serum levels of the soluble form of vascular endothelial growth factor receptor-1 were also significantly increased. Pregnant mice exposed to CIH2 seemed to have milder changes than pregnant mice exposed to CIH1.
Our results demonstrated that gestational CIH may induce gestational hypertension, proteinuria, fetal and placental growth restriction as well as impairments in placental angiogenesis and vascular remodeling.
孕妇易患阻塞性睡眠呼吸暂停（OSA）。基于 OSA 是普通人群高血压的独立危险因素这一事实，我们假设 OSA 的一个特征——慢性间歇性低氧（CIH）可能导致子痫前期。
将怀孕和未怀孕的 C57BL/6J 小鼠暴露于两种慢性间歇性低氧条件下：CIH1（21-5%O 交替）和 CIH2（21-10%O 交替），并持续至第 19 天。
在未怀孕的小鼠中，与各自的基础值相比，收缩压（SBP）从 CIH1 组的第 14 天开始升高，而 CIH2 组的 SBP 升高持续到第 19 天。与暴露于室内空气的怀孕小鼠相比，暴露于 CIH1 的怀孕小鼠从第 14 天开始保持升高的 SBP，同时伴有蛋白尿、胎儿和胎盘生长受限以及胎儿数量减少。暴露于 CIH1 的怀孕小鼠胎盘存在促血管生成和抗血管生成因子之间的失衡以及血管重塑受损。母体血清中可溶性血管内皮生长因子受体-1 水平也显著升高。暴露于 CIH2 的怀孕小鼠似乎比暴露于 CIH1 的怀孕小鼠变化更轻微。
我们的研究结果表明，妊娠期 CIH 可能导致妊娠期高血压、蛋白尿、胎儿和胎盘生长受限以及胎盘血管生成和血管重塑受损。
