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Mechanisms linking exposure to preeclampsia in utero and the risk for cardiovascular disease

Part of: DOHaD ANZ Conference 2018: Genes, Environment and Evolution

Published online by Cambridge University Press:  19 February 2020

Prabha H. Andraweera Open the ORCID record for Prabha H. Andraweera [Opens in a new window] ,
Kathryn L. Gatford Open the ORCID record for Kathryn L. Gatford [Opens in a new window] ,
Alison S. Care ,
Tina Bianco-Miotto ,
Zohra S. Lassi ,
Gus A. Dekker ,
Margaret Arstall  and
Claire T. Roberts
Prabha H. Andraweera*
Affiliation:
Adelaide Medical School, The University of Adelaide, Adelaide, Australia Robinson Research Institute, The University of Adelaide, Adelaide, Australia
Kathryn L. Gatford
Affiliation:
Adelaide Medical School, The University of Adelaide, Adelaide, Australia Robinson Research Institute, The University of Adelaide, Adelaide, Australia
Alison S. Care
Affiliation:
Adelaide Medical School, The University of Adelaide, Adelaide, Australia Robinson Research Institute, The University of Adelaide, Adelaide, Australia
Tina Bianco-Miotto
Affiliation:
Robinson Research Institute, The University of Adelaide, Adelaide, Australia School of Agriculture, Food and Wine, The University of Adelaide, Adelaide, Australia
Zohra S. Lassi
Affiliation:
Adelaide Medical School, The University of Adelaide, Adelaide, Australia Robinson Research Institute, The University of Adelaide, Adelaide, Australia
Gus A. Dekker
Affiliation:
Adelaide Medical School, The University of Adelaide, Adelaide, Australia Robinson Research Institute, The University of Adelaide, Adelaide, Australia Division of Women’s Health, Lyell McEwin Hospital, Elizabeth Vale, Australia
Margaret Arstall
Affiliation:
Adelaide Medical School, The University of Adelaide, Adelaide, Australia Department of Cardiology, Lyell McEwin Hospital, Elizabeth Vale, Australia
Claire T. Roberts
Affiliation:
Adelaide Medical School, The University of Adelaide, Adelaide, Australia Robinson Research Institute, The University of Adelaide, Adelaide, Australia
*
Address for correspondence: Prabha Andraweera, Adelaide Medical School, The Robinson Research Institute, The University of Adelaide, Adelaide, Australia. Email: prabha.andraweera@adelaide.edu.au
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Abstract

Preeclampsia (PE) is now recognised as a cardiovascular risk factor for women. Emerging evidence suggests that children exposed to PE in utero may also be at increased risk of cardiovascular disease (CVD) in later life. Individuals exposed to PE in utero have higher systolic and diastolic blood pressure and higher body mass index (BMI) compared to those not exposed to PE in utero. The aim of this review is to discuss the potential mechanisms driving the relationship between PE and offspring CVD. Exposure to an adverse intrauterine environment as a consequence of the pathophysiological changes that occur during a pregnancy complicated by PE is proposed as one mechanism that programs the fetus for future CVD risk. Consistent with this hypothesis, animal models of PE where progeny have been studied demonstrate causality for programming of offspring cardiovascular health by the preeclamptic environment. Shared alleles between mother and offspring, and shared lifestyle factors between mother and offspring provide alternate pathways explaining associations between PE and offspring CVD risk. In addition, adverse lifestyle habits can also act as second hits for those programmed for increased CVD risk. PE and CVD are both multifactorial diseases and, hence, identifying the relative contribution of PE to offspring risk for CVD is a very complex task. However, considering the emerging strong association between PE and CVD, those exposed to PE in utero may benefit from targeted primary CVD preventive strategies.

Keywords

Preeclampsiacardiovascular diseaseoffspringprogeny
Type
Review
Information
Journal of Developmental Origins of Health and Disease , Volume 11 , Issue 3 , June 2020 , pp. 235 - 242
Copyright
© The Author(s) 2020. Published by Cambridge University Press and the International Society for Developmental Origins of Health and Disease

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