疑似早产对胎儿心血管和代谢编程的影响：一项前瞻性队列研究方案。

Impact of suspected preterm labour in foetal cardiovascular and metabolic programming: a prospective cohort study protocol.

机构信息

Obstetrics and Gynaecology, Hospital Clinico Universitario Lozano Blesa, Zaragoza, Spain.

Pediatric Cardiology, Hospital Universitario Miguel Servet, Zaragoza, Spain.

出版信息

BMJ Open. 2024 Nov 24;14(11):e087430. doi: 10.1136/bmjopen-2024-087430.

DOI:10.1136/bmjopen-2024-087430

PMID:39581725

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11590803/

Abstract

INTRODUCTION

Suspected preterm labour (SPL) is an obstetric complication that occurs in 9% of all pregnancies and is the leading cause of antenatal hospital admissions. More than half of women with SPL deliver a premature baby which is a known risk factor for developing cardiovascular and metabolic disorders in childhood and later in adult life. On the other hand, the other half of these women will deliver at term, labelled as 'false preterm labour'. Although this has been thought to be a benign condition, accumulating evidence reported in recent years showed long-term effects for the foetus, neonate and infant even when birth occurs at term. However, the impact of SPL on cardiovascular and metabolic programming has not been studied yet. The aim of this prospective cohort study is to evaluate the impact of SPL on cardiac remodelling and function and on cardiovascular and metabolic profiles independently of gestational age at birth.

METHODS AND ANALYSIS

Prospective cohort study of subjects exposed and not exposed to an episode of SPL. Women with singleton pregnancies who are admitted at a tertiary hospital due to SPL and matched controls will be recruited. Evaluation of cardiovascular remodelling by foetal echocardiography will be performed during admission. Cord blood will be collected at birth in order to analyse different metabolomic footprints and several cardiovascular and metabolic risk biomarkers. Moreover, children will undergo an echocardiography 6 months after birth. The relationship between SPL and cardiovascular and metabolic programming will be modelled considering different covariates such as socioeconomic factors, perinatal characteristics, lifestyle, diet and exercise.

ETHICS AND DISSEMINATION

Ethical approval was granted in April 2020 from CEIC Aragón (CEICA) (C.P.-C.I. PI20/136). Study outcomes will be disseminated at international conferences and published in peer-reviewed scientific journals.

TRIAL REGISTRATION NUMBER

NCT05670665.

摘要

简介

早产临产（SPL）是一种产科并发症，发生在所有妊娠的 9%，是产前住院的主要原因。超过一半的 SPL 孕妇会分娩早产儿，这是儿童和成年后心血管和代谢紊乱的已知风险因素。另一方面，这些妇女中的另一半将足月分娩，称为“假性早产临产”。尽管人们认为这是一种良性疾病，但近年来的研究报道表明，即使在足月分娩时，这种情况也会对胎儿、新生儿和婴儿产生长期影响。然而，SPL 对心血管和代谢编程的影响尚未得到研究。本前瞻性队列研究旨在评估 SPL 对心脏重塑和功能以及心血管和代谢特征的影响，而不考虑出生时的胎龄。

方法和分析

对暴露于 SPL 和未暴露于 SPL 的受试者进行前瞻性队列研究。因 SPL 而在三级医院住院的单胎妊娠妇女将被招募。在入院期间将通过胎儿超声心动图评估心血管重塑。将在分娩时采集脐血，以分析不同的代谢组学特征和几种心血管和代谢风险生物标志物。此外，儿童将在出生后 6 个月进行超声心动图检查。将考虑社会经济因素、围产期特征、生活方式、饮食和运动等不同协变量，对 SPL 与心血管和代谢编程之间的关系进行建模。