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孕妇妊娠高血压疾病与新生儿心电图表现:哥本哈根婴儿心脏研究

Maternal hypertensive disorders of pregnancy and electrocardiographic findings among newborns: The Copenhagen Baby Heart Study.

作者信息

Nørskov Emil H, Pærregaard Maria M, Raja Anna A, Sillesen Anne-Sophie, Christensen Alex H, Bundgaard Henning, Boyd Heather A, Iversen Kasper K, Vøgg R Ottilia B

机构信息

Department of Cardiology, Herlev-Gentofte Hospital, Copenhagen University Hospital, Copenhagen, Denmark.

Department of Cardiology, The Heart Centre, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.

出版信息

Paediatr Perinat Epidemiol. 2025 Feb;39(2):123-132. doi: 10.1111/ppe.13117. Epub 2024 Oct 4.

Abstract

BACKGROUND

Maternal preeclampsia is associated with both congenital heart defects and changes in left ventricular structure and function in the offspring. Whether preeclampsia and gestational hypertension also affect the offspring's cardiac conduction system is unknown.

OBJECTIVES

This study assesses whether infants exposed to maternal hypertensive disorders of pregnancy (HDPs) exhibit changes in their electrocardiogram (ECG) compared with infants unexposed to HDPs.

METHODS

This population-based cohort study included newborns from the Copenhagen Baby Heart Study who had an ECG performed within 30 days of birth and had available obstetric information. ECG parameters of newborns exposed to maternal HDPs were compared with those of unexposed newborns using linear regression.

RESULTS

Our study cohort included 11,826 newborns, including 441 exposed to maternal preeclampsia and 320 exposed to gestational hypertension. Infants exposed to preeclampsia had prolonged QRS durations (adjusted mean difference 0.6 ms, 95% confidence interval [CI] 0.04, 1.16) and lower maximum amplitudes of the R-wave in V1 (adjusted mean difference, linear scale 0.95, 95% CI 0.90, 1.00), compared with unexposed infants. Exposure to maternal preeclampsia was not associated with changes in other ECG parameters. Exposure to gestational hypertension was associated with increased QT interval durations (QT Bazett, adjusted mean difference 2.48 ms, 95% CI -0.23, 5.20; QT Fridericia, adjusted mean difference 2.32 ms, 95% CI -0.19, 4.83).

CONCLUSIONS

Our findings suggest that the newborn cardiac conduction system is affected by exposure to maternal preeclampsia. This could reflect the previously described thickening of the left ventricular myocardium in infants exposed to preeclampsia.

摘要

背景

母亲子痫前期与后代先天性心脏缺陷以及左心室结构和功能的改变有关。子痫前期和妊娠期高血压是否也会影响后代的心脏传导系统尚不清楚。

目的

本研究评估暴露于母亲妊娠高血压疾病(HDPs)的婴儿与未暴露于HDPs的婴儿相比,其心电图(ECG)是否有变化。

方法

这项基于人群的队列研究纳入了哥本哈根婴儿心脏研究中的新生儿,这些新生儿在出生后30天内进行了心电图检查且有可用的产科信息。使用线性回归比较暴露于母亲HDPs的新生儿与未暴露新生儿的心电图参数。

结果

我们的研究队列包括11,826名新生儿,其中441名暴露于母亲子痫前期,320名暴露于妊娠期高血压。与未暴露的婴儿相比,暴露于子痫前期的婴儿QRS波时限延长(调整后平均差异0.6毫秒,95%置信区间[CI] 0.04,1.16),V1导联R波最大振幅降低(调整后平均差异,线性尺度0.95,95% CI 0.90,1.00)。暴露于母亲子痫前期与其他心电图参数的变化无关。暴露于妊娠期高血压与QT间期延长有关(QT Bazett,调整后平均差异2.48毫秒,95% CI -0.23,5.20;QT Fridericia,调整后平均差异2.32毫秒,95% CI -0.19,4.83)。

结论

我们的研究结果表明,新生儿心脏传导系统受到母亲子痫前期暴露的影响。这可能反映了先前描述的暴露于子痫前期的婴儿左心室心肌增厚。

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