Prenatal and Postnatal Cardiac Development in Offspring of Hypertensive Pregnancies

Christina Y.L. Aye; Adam J. Lewandowski; Pablo Lamata; Ross Upton; Esther Davis; Eric O. Ohuma; Yvonne Kenworthy; Henry Boardman; Annabelle L. Frost; Satish Adwani; Kenny McCormick; Paul Leeson

doi:10.1161/JAHA.119.014586

Prenatal and Postnatal Cardiac Development in Offspring of Hypertensive Pregnancies

Christina Y.L. Aye, Adam J. Lewandowski, Pablo Lamata, Ross Upton, Esther Davis, Eric O. Ohuma, Yvonne Kenworthy, Henry Boardman, Annabelle L. Frost, Satish Adwani, Kenny McCormick, Paul Leeson

Biomedical Engineering Department

Research output: Contribution to journal › Article › peer-review

23 Citations (Scopus)

Abstract

Background Pregnancy complications such as preterm birth and fetal growth restriction are associated with altered prenatal and postnatal cardiac development. We studied whether there were changes related specifically to pregnancy hypertension. Methods and Results Left and right ventricular volumes, mass, and function were assessed at birth and 3 months of age by echocardiography in 134 term-born infants. Fifty-four had been born to mothers who had normotensive pregnancy and 80 had a diagnosis of preeclampsia or pregnancy-induced hypertension. Differences between groups were interpreted, taking into account severity of pregnancy disorder, sex, body size, and blood pressure. Left and right ventricular mass indexed to body surface area (LVMI and RVMI) were similar in both groups at birth (LVMI 20.9±3.7 versus 20.6±4.0 g/m2, P=0.64, RVMI 17.5±3.7 versus 18.1±4.7 g/m2, P=0.57). However, right ventricular end diastolic volume index was significantly smaller in those born to hypertensive pregnancy (16.8±5.3 versus 12.7±4.7 mL/m2, P=0.001), persisting at 3 months of age (16.4±3.2 versus 14.4±4.8 mL/m2, P=0.04). By 3 months of age these infants also had significantly greater LVMI and RVMI (LVMI 24.9±4.6 versus 26.8±4.9 g/m2, P=0.04; RVMI 17.1±4.2 versus 21.1±3.9 g/m2, P<0.001). Differences in RVMI and right ventricular end diastolic volume index at 3 months, but not left ventricular measures, correlated with severity of the hypertensive disorder. No differences in systolic or diastolic function were evident. Conclusions Infants born at term to a hypertensive pregnancy have evidence of both prenatal and postnatal differences in cardiac development, with right ventricular changes proportional to the severity of the pregnancy disorder. Whether differences persist long term as well as their underlying cause and relationship to increased cardiovascular risk requires further study.

Original language	English
Pages (from-to)	e014586
Journal	Journal of the American Heart Association
Volume	9
Issue number	9
DOIs	https://doi.org/10.1161/JAHA.119.014586
Publication status	Published - 5 May 2020

Keywords

high blood pressure
hypertension
preeclampsia
pregnancy
ventricular

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.1161/JAHA.119.014586

Cite this

@article{0ace38b8ed214eb085ddbc33369cd3c8,

title = "Prenatal and Postnatal Cardiac Development in Offspring of Hypertensive Pregnancies",

abstract = "Background Pregnancy complications such as preterm birth and fetal growth restriction are associated with altered prenatal and postnatal cardiac development. We studied whether there were changes related specifically to pregnancy hypertension. Methods and Results Left and right ventricular volumes, mass, and function were assessed at birth and 3 months of age by echocardiography in 134 term-born infants. Fifty-four had been born to mothers who had normotensive pregnancy and 80 had a diagnosis of preeclampsia or pregnancy-induced hypertension. Differences between groups were interpreted, taking into account severity of pregnancy disorder, sex, body size, and blood pressure. Left and right ventricular mass indexed to body surface area (LVMI and RVMI) were similar in both groups at birth (LVMI 20.9±3.7 versus 20.6±4.0 g/m2, P=0.64, RVMI 17.5±3.7 versus 18.1±4.7 g/m2, P=0.57). However, right ventricular end diastolic volume index was significantly smaller in those born to hypertensive pregnancy (16.8±5.3 versus 12.7±4.7 mL/m2, P=0.001), persisting at 3 months of age (16.4±3.2 versus 14.4±4.8 mL/m2, P=0.04). By 3 months of age these infants also had significantly greater LVMI and RVMI (LVMI 24.9±4.6 versus 26.8±4.9 g/m2, P=0.04; RVMI 17.1±4.2 versus 21.1±3.9 g/m2, P<0.001). Differences in RVMI and right ventricular end diastolic volume index at 3 months, but not left ventricular measures, correlated with severity of the hypertensive disorder. No differences in systolic or diastolic function were evident. Conclusions Infants born at term to a hypertensive pregnancy have evidence of both prenatal and postnatal differences in cardiac development, with right ventricular changes proportional to the severity of the pregnancy disorder. Whether differences persist long term as well as their underlying cause and relationship to increased cardiovascular risk requires further study.",

keywords = "high blood pressure, hypertension, preeclampsia, pregnancy, ventricular",

author = "Aye, {Christina Y.L.} and Lewandowski, {Adam J.} and Pablo Lamata and Ross Upton and Esther Davis and Ohuma, {Eric O.} and Yvonne Kenworthy and Henry Boardman and Frost, {Annabelle L.} and Satish Adwani and Kenny McCormick and Paul Leeson",

year = "2020",

month = may,

day = "5",

doi = "10.1161/JAHA.119.014586",

language = "English",

volume = "9",

pages = "e014586",

journal = "Journal of the American Heart Association",

issn = "2047-9980",

publisher = "American Heart Association, Inc.",

number = "9",

}

TY - JOUR

T1 - Prenatal and Postnatal Cardiac Development in Offspring of Hypertensive Pregnancies

AU - Aye, Christina Y.L.

AU - Lewandowski, Adam J.

AU - Lamata, Pablo

AU - Upton, Ross

AU - Davis, Esther

AU - Ohuma, Eric O.

AU - Kenworthy, Yvonne

AU - Boardman, Henry

AU - Frost, Annabelle L.

AU - Adwani, Satish

AU - McCormick, Kenny

AU - Leeson, Paul

PY - 2020/5/5

Y1 - 2020/5/5

N2 - Background Pregnancy complications such as preterm birth and fetal growth restriction are associated with altered prenatal and postnatal cardiac development. We studied whether there were changes related specifically to pregnancy hypertension. Methods and Results Left and right ventricular volumes, mass, and function were assessed at birth and 3 months of age by echocardiography in 134 term-born infants. Fifty-four had been born to mothers who had normotensive pregnancy and 80 had a diagnosis of preeclampsia or pregnancy-induced hypertension. Differences between groups were interpreted, taking into account severity of pregnancy disorder, sex, body size, and blood pressure. Left and right ventricular mass indexed to body surface area (LVMI and RVMI) were similar in both groups at birth (LVMI 20.9±3.7 versus 20.6±4.0 g/m2, P=0.64, RVMI 17.5±3.7 versus 18.1±4.7 g/m2, P=0.57). However, right ventricular end diastolic volume index was significantly smaller in those born to hypertensive pregnancy (16.8±5.3 versus 12.7±4.7 mL/m2, P=0.001), persisting at 3 months of age (16.4±3.2 versus 14.4±4.8 mL/m2, P=0.04). By 3 months of age these infants also had significantly greater LVMI and RVMI (LVMI 24.9±4.6 versus 26.8±4.9 g/m2, P=0.04; RVMI 17.1±4.2 versus 21.1±3.9 g/m2, P<0.001). Differences in RVMI and right ventricular end diastolic volume index at 3 months, but not left ventricular measures, correlated with severity of the hypertensive disorder. No differences in systolic or diastolic function were evident. Conclusions Infants born at term to a hypertensive pregnancy have evidence of both prenatal and postnatal differences in cardiac development, with right ventricular changes proportional to the severity of the pregnancy disorder. Whether differences persist long term as well as their underlying cause and relationship to increased cardiovascular risk requires further study.

AB - Background Pregnancy complications such as preterm birth and fetal growth restriction are associated with altered prenatal and postnatal cardiac development. We studied whether there were changes related specifically to pregnancy hypertension. Methods and Results Left and right ventricular volumes, mass, and function were assessed at birth and 3 months of age by echocardiography in 134 term-born infants. Fifty-four had been born to mothers who had normotensive pregnancy and 80 had a diagnosis of preeclampsia or pregnancy-induced hypertension. Differences between groups were interpreted, taking into account severity of pregnancy disorder, sex, body size, and blood pressure. Left and right ventricular mass indexed to body surface area (LVMI and RVMI) were similar in both groups at birth (LVMI 20.9±3.7 versus 20.6±4.0 g/m2, P=0.64, RVMI 17.5±3.7 versus 18.1±4.7 g/m2, P=0.57). However, right ventricular end diastolic volume index was significantly smaller in those born to hypertensive pregnancy (16.8±5.3 versus 12.7±4.7 mL/m2, P=0.001), persisting at 3 months of age (16.4±3.2 versus 14.4±4.8 mL/m2, P=0.04). By 3 months of age these infants also had significantly greater LVMI and RVMI (LVMI 24.9±4.6 versus 26.8±4.9 g/m2, P=0.04; RVMI 17.1±4.2 versus 21.1±3.9 g/m2, P<0.001). Differences in RVMI and right ventricular end diastolic volume index at 3 months, but not left ventricular measures, correlated with severity of the hypertensive disorder. No differences in systolic or diastolic function were evident. Conclusions Infants born at term to a hypertensive pregnancy have evidence of both prenatal and postnatal differences in cardiac development, with right ventricular changes proportional to the severity of the pregnancy disorder. Whether differences persist long term as well as their underlying cause and relationship to increased cardiovascular risk requires further study.

KW - high blood pressure

KW - hypertension

KW - preeclampsia

KW - pregnancy

KW - ventricular

UR - http://www.scopus.com/inward/record.url?scp=85084270861&partnerID=8YFLogxK

U2 - 10.1161/JAHA.119.014586

DO - 10.1161/JAHA.119.014586

M3 - Article

C2 - 32349586

AN - SCOPUS:85084270861

SN - 2047-9980

VL - 9

SP - e014586

JO - Journal of the American Heart Association

JF - Journal of the American Heart Association

IS - 9

ER -

Prenatal and Postnatal Cardiac Development in Offspring of Hypertensive Pregnancies

Abstract

Keywords

UN SDGs

Access to Document

Other files and links

Fingerprint

Cite this