Preeclampsia – long-term effects on mother and child
DOI:
https://doi.org/10.12775/JEHS.2021.11.08.027Keywords
Preeclampsia, hypertension, pregnancy, cardiovascular complications, biomarkersAbstract
Preeclampsia (PE) is a pregnancy complication that affects 5% to 8% of all pregnancies. It is a leading cause of maternal mortality that contributes annually more than 60,000 maternal deaths all over the world. Data submitted so far by clinicians are still insufficient to completely understand the disease. Despite many researches, the prediction of patients suffering from PE remains difficult. Moreover therapeutic methods are also limited and concentrated on symptomatic treatment and early termination of pregnancy. The aim of the presented article is to review current research on the PE and its long-term effects on mother and child. PE is defined as a hypertension developing after 20 weeks of gestation with at least one of the following symptoms: proteinuria, maternal organ dysfunction or foetal growth restriction. Because initially patients may be completely asymptomatic, the diagnosis is usually difficult. Untreated PE may lead to the death of both mother and neonate. In later life it predisposes woman and child to cardiovascular and metabolic diseases. Maternal consequences are related to increased risk of hypertension, stroke, thrombosis or chronic kidney disease, whilst offspring implications are directly correlated with hypertension, increased body mass index, hormonal changes and reductions in cognitive functions. In the future there is a need to develop more effective diagnostic methods of PE. Comprehensive understanding of the pathophysiology would allow to avoid many negative long-term effects and reduce its mortality rate.
References
Karumanchi SA, Granger JP. Preeclampsia and Pregnancy-Related Hypertensive Disorders. Hypertension. 2016; 67(2): 238-242.
Backes CH, Markham K, Moorehead P, et al. Maternal preeclampsia and neonatal outcomes. J Pregnancy. 2011; 2011:214365.
Jeyabalan A. Epidemiology of preeclampsia: impact of obesity. Nutr Rev. 2013; 71(1): 18-25.
Redman EK, Hauspurg A, Hubel CA, et al. Clinical Course, Associated Factors, and Blood Pressure Profile of Delayed-Onset Postpartum Preeclampsia. Obstet Gynecol. 2019; 134(5): 995-1001.
Bartsch E, Medcalf KE, Park AL, et al. High Risk of Pre-eclampsia Identification Group. Clinical risk factors for pre-eclampsia determined in early pregnancy: systematic review and meta-analysis of large cohort studies. BMJ. 2016; 353:i1753.
Phipps EA, Thadhani R, Benzing T, et al. Pre-eclampsia: pathogenesis, novel diagnostics and therapies. Nat Rev Nephrol. 2019; 15(5): 275-289.
Armaly Z, Jadaon JE, Jabbour A, et al. Preeclampsia: Novel Mechanisms and Potential Therapeutic Approaches. Front Physiol. 2018; 9:973.
Amaral LM, Wallace K, Owens M, et al. Pathophysiology and Current Clinical Management of Preeclampsia. Curr Hypertens Rep. 2017; 19(8): 61.
Pillay P, Moodley K, Moodley J, et al. Placenta-derived exosomes: potential biomarkers of preeclampsia. Int J Nanomedicine. 2017; 12:8009-8023.
Campbell N, LaMarca B, Cunningham MW Jr. The Role of Agonistic Autoantibodies to the Angiotensin II Type 1 Receptor (AT1-AA) in Pathophysiology of Preeclampsia. Curr Pharm Biotechnol. 2018; 19(10): 781-785.
Dasinger JH, Abais-Battad JM, Mattson DL. Influences of environmental factors during preeclampsia. Am J Physiol Regul Integr Comp Physiol. 2020; 319(1): 26-32.
Nikuei P, Rajaei M, Roozbeh N, et al. Diagnostic accuracy of sFlt1/PlGF ratio as a marker for preeclampsia. BMC Pregnancy Childbirth. 2020; 20(1): 80.
Bian X, Biswas A, Huang X, et al. Short-Term Prediction of Adverse Outcomes Using the sFlt-1 (Soluble fms-Like Tyrosine Kinase 1)/PlGF (Placental Growth Factor) Ratio in Asian Women With Suspected Preeclampsia. Hypertension. 2019; 74(1): 164-172.
Aneman I, Pienaar D, Suvakov S, et al. Mechanisms of Key Innate Immune Cells in Early- and Late-Onset Preeclampsia. Front Immunol. 2020; 11:1864.
Phipps E, Prasanna D, Brima W, Jim B. Preeclampsia: Updates in Pathogenesis, Definitions, and Guidelines. Clin J Am Soc Nephrol. 2016; 11(6): 1102-1113.
Filipek A, Jurewicz E. Preeklampsja – choroba kobiet w ciąży [Preeclampsia - a disease of pregnant women]. Postepy Biochem. 2018; 64(4): 232-229.
Huppertz B. The Critical Role of Abnormal Trophoblast Development in the Etiology of Preeclampsia. Curr Pharm Biotechnol. 2018; 19(10): 771-780.
Poon LC, Shennan A, Hyett JA, et al. The International Federation of Gynecology and Obstetrics (FIGO) initiative on pre-eclampsia: A pragmatic guide for first-trimester screening and prevention. Int J Gynaecol Obstet. 2019; 145: 1-33.
Serrano-Díaz NC, Gamboa-Delgado EM, Domínguez-Urrego CL, et al. Vitamin D and risk of preeclampsia: A systematic review and meta-analysis. Biomedica. 2018; 38 (1): 43-53.
Khaing W, Vallibhakara SA, Tantrakul V, et al. Calcium and Vitamin D Supplementation for Prevention of Preeclampsia: A Systematic Review and Network Meta-Analysis. Nutrients. 2017; 9(10): 1141.
Tomimatsu T, Mimura K, Matsuzaki S, et al. Preeclampsia: Maternal Systemic Vascular Disorder Caused by Generalized Endothelial Dysfunction Due to Placental Antiangiogenic Factors. Int J Mol Sci. 2019; 20(17): 4246.
Turbeville HR, Sasser JM. Preeclampsia beyond pregnancy: long-term consequences for mother and child. Am J Physiol Renal Physiol. 2020; 318(6):F1315-F1326.
Mustafa R, Ahmed S, Gupta A, et al. A comprehensive review of hypertension in pregnancy. J Pregnancy. 2012; 2012:105918.
Bossung V, Fortmann MI, Fusch C, et al. Neonatal Outcome After Preeclampsia and HELLP Syndrome: A Population-Based Cohort Study in Germany. Front Pediatr. 2020; 8:579293.
Hellström A, Smith LE, Dammann O. Retinopathy of prematurity. Lancet. 2013; 382(9902): 1445-1457.
Grotegut CA. Prevention of preeclampsia. J Clin Invest. 2016; 126(12): 4396-4398.
Downloads
Published
How to Cite
Issue
Section
License
The periodical offers access to content in the Open Access system under the Creative Commons Attribution-NonCommercial-ShareAlike 4.0
Stats
Number of views and downloads: 743
Number of citations: 0