Pregnancy Complications and Later Development of Hypertension
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WOMEN AND HEART DISEASE (J ROBINSON, SECTION EDITOR)
Pregnancy Complications and Later Development of Hypertension Suttira Intapad & Barbara T. Alexander
Published online: 22 March 2013 # Springer Science+Business Media New York 2013
Abstract Pregnancy complications such as preeclampsia and diabetes affect approximately 5 to 10 % of all pregnancies and compromise maternal and fetal health during gestation. Complications during pregnancy may also contribute to the development of hypertension and future cardiovascular risk in the mother. Moreover, fetal exposure to hypertension and diabetes during pregnancy can program hypertension and cardiovascular disease in the offspring. Transgenerational transmission of programmed cardiovascular risk highlights the importance of understanding the mechanisms that link complications during pregnancy with later hypertension in her offspring and subsequent generations. However, experimental studies are needed to investigate the cause and effect of increased blood pressure in the mother following a complicated pregnancy and provide insight into the development of preventative measures that may improve the long-term cardiovascular health of women and their offspring. Keywords Pregnancy complications . Hypertension . Preeclampsia . Diabetes . Fetal programming . Transgenerational
Introduction Pregnancy is associated with profound physiological and anatomical changes in the mother that occur in order to meet the growing metabolic needs of the developing fetus and placenta [1]. However, complications such as hypertension and diabetes that occur during pregnancy compromise the health of the S. Intapad : B. T. Alexander (*) Department of Physiology and Biophysics and the Women’s Health Research Center, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS 39216, USA e-mail: [email protected]
mother and the fetus [2, 3] (Fig. 1). Recent epidemiological studies suggest that adverse consequences of complications during pregnancy can persist well beyond the gestational period in the mother and child [4, 5] (Fig. 1). Experimental studies providing mechanistic insight into the causative factors linked to future risk of hypertension in the mother are limited. However, experimental studies investigating the mechanisms that contribute to the development of hypertension in the offspring of mothers with complications during pregnancy are providing significant insight into the etiology of fetal programming of chronic disease. This review highlights the impact of complications during pregnancy on future hypertension and cardiovascular (CV) in both the mother and child with a particular emphasis on potential mechanism.
Pregnancy Complications and Maternal Hypertension and Cardiovascular Health Preeclampsia is a pregnancy-specific disorder that is a leading cause of maternal and fetal mortality and morbidity [3]. Preeclampsia is defined as new onset of an elevated blood pressure of 140/90 mmHg or more in the presence of at least 0.3 g of protein in a 24 h urine sample [6].
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