Qi Ying, Lin Zixuan, Lu Hanzhang, Zhao Pengfei, Hou Yang, Mao Jian
Department of Radiology, Shengjing Hospital of China Medical University, Shenyang, China.
Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, MD, United States.
Front Physiol. 2022 Feb 28;13:756386. doi: 10.3389/fphys.2022.756386. eCollection 2022.
Pregnancy-induced hypertension (PIH) is common and may affect maternal and children's healthcare. However, the neurobiological status of neonates born from mothers with PIH has yet to be elucidated. The present study employed physiological imaging to investigate the association between maternal PIH and a number of neonatal health parameters, including cerebral metabolism, hemodynamics, and pathophysiological vulnerabilities. Following the acquisition of ethical approval, we recruited 16 neonates with maternal PIH and 22 normal neonates (non-PIH) as controls. All neonates underwent magnetic resonance imaging (MRI) of the brain. Phase-contrast (PC) MRI and T2-relaxation-under-spin-tagging (TRUST) MRI were performed to determine global cerebral blood flow, oxygen extraction fraction (OEF), and cerebral metabolic rate of oxygen (CMRO). These physiological parameters were then compared between PIH neonates and controls. Linear regression analysis was performed to investigate the associations between maternal PIH and each of the physiological parameters. Receiver operating characteristic curves (ROCs) were used to determine whether maternal systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial pressure (MAP) which could facilitate the diagnosis of neonatal brain injuries. PIH neonates showed significantly lower OEF (25.5 ± 8.8% vs. 32.6 ± 7.3%, = 0.01) and CMRO (29.7 ± 9.4 vs. 40.9 ± 15.0 μmol/100 g/min, = 0.01) compared to the controls. Maternal blood pressure levels [PIH or non-PIH groups, each one standard deviation (SD) increase in SBP, DBP, and MAP, respectively] were negatively associated with OEF [regression coefficient (β) = -7.9, = 0.007; β = -4.2, = 0.004; β = -3.6, = 0.02; β = -4.0, = 0.008, respectively). Furthermore, each one SD increase in maternal DBP and MAP was negatively associated with CMRO (β = -4.7, = 0.03; β = -4.4, = 0.04, respectively). The areas under the curves (AUCs) with 95% confidence intervals (CIs) for maternal SBP, DBP, and MAP were 0.90 (0.80-0.97), 0.85 (0.73-0.97), and 0.89 (0.76-0.99), respectively. The AUC values for maternal SBP, DBP, and MAP indicated good diagnostic ability for identifying neonatal brain injuries. The present study demonstrated that maternal PIH may be associated with a lower oxygen extraction and lower cerebral metabolism in neonates.
妊娠高血压（PIH）很常见，可能会影响母婴保健。然而，PIH母亲所生新生儿的神经生物学状况尚未阐明。本研究采用生理成像技术来研究母亲PIH与一些新生儿健康参数之间的关联，这些参数包括脑代谢、血流动力学和病理生理易损性。在获得伦理批准后，我们招募了16例母亲患有PIH的新生儿和22例正常新生儿（非PIH）作为对照。所有新生儿均接受了脑部磁共振成像（MRI）检查。进行了相位对比（PC）MRI和自旋标记下的T2弛豫（TRUST）MRI，以确定全脑血流量、氧摄取分数（OEF）和脑氧代谢率（CMRO）。然后比较了PIH新生儿和对照组之间的这些生理参数。进行线性回归分析以研究母亲PIH与每个生理参数之间的关联。使用受试者工作特征曲线（ROCs）来确定母亲的收缩压（SBP）、舒张压（DBP）和平均动脉压（MAP）是否有助于诊断新生儿脑损伤。与对照组相比，PIH新生儿的OEF（25.5±8.8%对32.6±7.3%，P = 0.01）和CMRO（29.7±9.4对40.9±15.0μmol/100 g/min，P = 0.01）显著降低。母亲的血压水平[PIH或非PIH组，SBP、DBP和MAP分别每增加一个标准差（SD）]与OEF呈负相关[回归系数（β）=-7.9，P = 0.007；β=-4.2，P = 0.004；β=-3.6，P = 0.02；β=-4.0，P = 0.008]。此外，母亲DBP和MAP每增加一个SD均与CMRO呈负相关（β=-4.7，P = 0.03；β=-4.4，P = 0.04）。母亲SBP、DBP和MAP的曲线下面积（AUC）及其95%置信区间（CI）分别为0.90（0.80 - 0.97）、0.85（0.73 - 0.97）和0.89（0.76 - 0.99）。母亲SBP、DBP和MAP的AUC值表明其对识别新生儿脑损伤具有良好的诊断能力。本研究表明，母亲PIH可能与新生儿较低的氧摄取和较低的脑代谢有关。
