Moustakli Efthalia, Potiris Anastasios, Zikopoulos Athanasios, Mavrogianni Despoina, Kathopoulis Nikolaos, Drakaki Eirini, Anagnostaki Ismini, Tsakiridis Ioannis, Dagklis Themistoklis, Skentou Charikleia, Drakakis Peter, Christopoulos Panagiotis, Stavros Sofoklis
Laboratory of Medical Genetics, Faculty of Medicine, School of Health Sciences, University of Ioannina, 451 10 Ioannina, Greece.
Third Department of Obstetrics and Gynecology, University General Hospital "ATTIKON", Medical School, National and Kapodistrian University of Athens, 124 62 Athens, Greece.
Int J Mol Sci. 2025 Jun 24;26(13):6034. doi: 10.3390/ijms26136034.
The prevalence, pathogenesis, and long-term consequences of hypertension differ significantly across the sexes, and pregnancy is a special physiological stress test that can reveal a woman's underlying cardiovascular sensitivity. In addition to being direct risks to the health of the mother and fetus, hypertensive disorders of pregnancy (HDPs), especially preeclampsia, are also reliable indicators of future hypertension and cardiovascular disease in those who are afflicted. Fetal sex has a substantial impact on maternal vascular adaptation, according to new data from placental transcriptomics and epigenetics. This may be due to variations in the expression of angiogenic, immunomodulatory, and vasoactive genes. Sex-specific patterns of placental function, inflammation, and endothelium control are specifically influenced by X-linked gene dosage, escape from X-inactivation, and sex chromosomal composition. These biological variations highlight the placenta's potential function as a mediator and indicator of maternal cardiovascular risk, and they may help to explain why the incidence and severity of hypertensive pregnancy challenges vary depending on the fetal sex. The purpose of this review is to summarize the state of the art regarding how placental genetics and fetal sex influence maternal hypertensive risk both during and after pregnancy. Additionally, it will investigate how these findings may influence sex-specific cardiovascular screening, prediction, and prevention methods.
高血压的患病率、发病机制和长期后果在性别上存在显著差异，而怀孕是一种特殊的生理应激测试，能够揭示女性潜在的心血管敏感性。妊娠高血压疾病（HDPs），尤其是先兆子痫，不仅对母亲和胎儿的健康构成直接风险，也是患病女性未来患高血压和心血管疾病的可靠指标。胎盘转录组学和表观遗传学的新数据表明，胎儿性别对母体血管适应有重大影响。这可能是由于血管生成、免疫调节和血管活性基因表达的差异所致。胎盘功能、炎症和内皮控制的性别特异性模式具体受X连锁基因剂量、X染色体失活逃逸和性染色体组成的影响。这些生物学差异凸显了胎盘作为母体心血管风险的调节因子和指标的潜在功能，它们可能有助于解释为什么妊娠高血压疾病的发病率和严重程度因胎儿性别而异。本综述的目的是总结关于胎盘遗传学和胎儿性别如何影响孕期及产后母体高血压风险的最新研究状况。此外，还将探讨这些发现如何影响针对不同性别的心血管筛查、预测和预防方法。
