Escudero Carlos, Kupka Ellen, Ibañez Belen, Sandoval Hermes, Troncoso Felipe, Wikström Anna-Karin, López-Espíndola Daniela, Acurio Jesenia, Torres-Vergara Pablo, Bergman Lina
Vascular Physiology Laboratory, Department of Basic Sciences, Faculty of Basic Sciences, University of Bío-Bío, Chillán, Chile (C.E., B.I., H.S., F.T., J.A.).
Group of Research and Innovation in Vascular Health (GRIVAS Health), Chillán, Chile (C.E., J.A., P.T.-V.).
Hypertension. 2023 Feb;80(2):242-256. doi: 10.1161/HYPERTENSIONAHA.122.19408. Epub 2022 Aug 3.
Preeclampsia is a maternal syndrome characterized by the new onset of hypertension and proteinuria after 20 weeks of gestation associated with multisystemic complications, including brain alterations. Indeed, brain complications associated with preeclampsia are the leading direct causes of fetal and maternal morbidity and mortality, especially in low- and middle-income countries. In addition to the well-recognized long-term adverse cardiovascular effects of preeclampsia, women who have had preeclampsia have higher risk of stroke, dementia, intracerebral white matter lesions, epilepsy, and perhaps also cognitive decline postpartum. Furthermore, increasing evidence has also associated preeclampsia with similar cognitive and cerebral disorders in the offspring. However, the mechanistic links between these associations remain unresolved. This article summarizes the current knowledge about the cerebrovascular complications elicited by preeclampsia and the potential pathophysiological mechanisms involved, emphasizing the impaired brain vascular function in the mother and their offspring.
子痫前期是一种孕产妇综合征,其特征为妊娠20周后新发高血压和蛋白尿,并伴有多系统并发症,包括脑部病变。事实上,与子痫前期相关的脑部并发症是胎儿和孕产妇发病及死亡的主要直接原因,尤其是在低收入和中等收入国家。除了子痫前期公认的长期不良心血管影响外,患过子痫前期的女性患中风、痴呆、脑内白质病变、癫痫的风险更高,产后认知能力下降的风险可能也更高。此外,越来越多的证据还表明子痫前期与后代类似的认知和脑部疾病有关。然而,这些关联之间的机制联系仍未得到解决。本文总结了目前关于子痫前期引发的脑血管并发症以及潜在病理生理机制的知识,重点强调了母亲及其后代脑血管功能受损的情况。