Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
Minerva Foundation Institute for Medical Research, Helsinki, Finland.
J Hypertens. 2023 Sep 1;41(9):1429-1437. doi: 10.1097/HJH.0000000000003485. Epub 2023 Jun 19.
The aim was to study if children following preeclampsia (PE) develop alterations in blood pressure (BP) and arterial stiffness already early in life, and how this is associated with gestational, perinatal and child cardiovascular risk profiles.
One hundred eighty-two PE (46 early-onset with diagnosis before 34 gestational weeks, and 136 late-onset) and 85 non-PE children were assessed 8-12 years from delivery. Office and 24-h ambulatory BP, body composition, anthropometrics, lipids, glucose, inflammatory markers, and tonometry-derived pulse wave velocity (PWV) and central BPs were assessed.
Office BP, central BPs, 24-h systolic BP (SBP) and pulse pressure (PP) were higher in PE compared with non-PE. Early-onset PE children had the highest SBP, SBP-loads, and PP. SBP nondipping during night-time was common among PE. The higher child 24-h mean SBP among PE was explained by maternal SBP at first antenatal visit and prematurity (birth weight or gestational weeks), but child 24-h mean PP remained related with PE and child adiposity after adjustments. Central and peripheral PWVs were elevated in late-onset PE subgroup only and attributed to child age and anthropometrics, child and maternal office SBP at follow-up, but relations with maternal antenatal SBPs and prematurity were not found. There were no differences in body anthropometrics, composition, or blood parameters.
PE children develop an adverse BP profile and arterial stiffness early in life. PE-related BP is related with maternal gestational BP and prematurity, whereas arterial stiffness is determined by child characteristics at follow-up. The alterations in BP are pronounced in early-onset PE.Clinical Trial Registration information: https://clinicaltrials.gov/ct2/show/NCT04676295ClinicalTrials.gov Identifier: NCT04676295.
本研究旨在探讨早发型子痫前期(PE)患儿在生命早期是否会出现血压(BP)和动脉僵硬度的改变,以及这种改变与妊娠、围生期和儿童心血管风险特征的关系。
本研究纳入了 182 例 PE 患儿(46 例为早发型,诊断时间在 34 孕周之前,136 例为晚发型)和 85 例非 PE 患儿。这些患儿在分娩后 8-12 年接受了诊室血压和 24 小时动态血压、身体成分、人体测量学、血脂、血糖、炎症标志物以及脉搏波速度(PWV)和中心血压的检测。
与非 PE 患儿相比,PE 患儿的诊室血压、中心血压、24 小时收缩压(SBP)和脉压(PP)更高。早发型 PE 患儿的 SBP、SBP 负荷和 PP 最高。PE 患儿夜间 SBP 非杓型节律较为常见。PE 患儿 24 小时平均 SBP 升高与母亲首次产前检查时的 SBP 和早产(出生体重或孕周)有关,但校正后,PE 与儿童肥胖相关的 24 小时平均 PP 仍与 PE 相关。仅在晚发型 PE 亚组中,中心和外周 PWV 升高,这与儿童年龄和人体测量学、随访时儿童和母亲的诊室 SBP 有关,但与母亲产前 SBP 和早产无关。两组患儿的身体形态、组成或血液参数均无差异。
PE 患儿在生命早期就会出现不良的血压特征和动脉僵硬度。与 PE 相关的 BP 与母亲的妊娠 BP 和早产有关,而动脉僵硬度则由随访时儿童的特征决定。早发型 PE 患儿的 BP 改变更为明显。
https://clinicaltrials.gov/ct2/show/NCT04676295
NCT04676295