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孕前压力可导致孕期和产后母体血管功能障碍。

Pre-pregnancy stress induces maternal vascular dysfunction during pregnancy and postpartum.

机构信息

Magee-Womens Research Institute, Pittsburgh, PA, 15213, USA.

Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA, 15213, USA.

出版信息

Reprod Sci. 2023 Nov;30(11):3197-3211. doi: 10.1007/s43032-023-01248-2. Epub 2023 May 23.

Abstract

An estimated 20% of women suffer from a stress-related mood disorder including depression and anxiety during and after pregnancy, making these disorders among the most common complications of pregnancy. These stress-related disorders are associated with adverse pregnancy outcomes including gestational hypertension and preeclampsia, which are associated with poor cardiometabolic health postpartum. Despite these associations, the direct impact of stress and related disorders on maternal vascular health, and contributing mechanisms, remain understudied. The aim of this study was to investigate the effect of pre-pregnancy stress on maternal vascular outcomes in a BALB/c mouse model of chronic unpredictable stress. Maternal blood pressure and ex-vivo vascular function were investigated during pregnancy and postpartum. Offspring characteristics were assessed at the end of pregnancy and postpartum. Main findings show that pre-pregnancy stress exposure increased blood pressure during mid and late pregnancy and impaired ex vivo vascular function at the end of pregnancy. These effects persisted into the postpartum period, suggesting a long-term effect of stress on maternal vascular health, which appear to be partially attributable to disruptions in nitric oxide (NO) pathway signaling. These data suggest exposure to stress and related disorders, even prior to pregnancy, can contribute to vascular complications during pregnancy and postpartum.

摘要

据估计,20%的女性在怀孕期间和产后会遭受与压力相关的情绪障碍,包括抑郁和焦虑,使这些障碍成为妊娠最常见的并发症之一。这些与压力相关的障碍与不良的妊娠结局有关,包括妊娠期高血压和子痫前期,这与产后不良的心血代谢健康有关。尽管存在这些关联,但压力和相关障碍对产妇血管健康的直接影响以及促成这些影响的机制仍未得到充分研究。本研究旨在探讨孕前压力对慢性不可预测应激 BALB/c 小鼠模型中母体血管结局的影响。在妊娠和产后期间研究了母体血压和离体血管功能。在妊娠结束和产后评估了后代特征。主要发现表明,孕前压力暴露会增加中晚期妊娠期间的血压,并在妊娠结束时损害离体血管功能。这些影响持续到产后时期,表明压力对产妇血管健康的长期影响,这似乎部分归因于一氧化氮(NO)途径信号的中断。这些数据表明,即使在怀孕之前,压力和相关障碍的暴露也会导致怀孕期间和产后的血管并发症。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b4aa/10643410/7b91d9c99d77/43032_2023_1248_Fig1_HTML.jpg

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