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Author Spotlight: Modeling an Aspect of Preeclampsia in Female Mice Using Hypoxic Human Placenta-Derived Small Extracellular Vesicles
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Placental syndromes and long-term risk of hypertension

Abigail Fraser1, Janet M Catov2

  • 1Population Health Sciences, Bristol Medical School and the MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK. abigail.fraser@bristol.ac.uk.

Journal of Human Hypertension
|January 26, 2023
PubMed

Insights

High blood pressure before pregnancy increases risks for placental syndromes, impacting maternal cardiovascular health long-term. Further research is needed to clarify the cause-and-effect relationship for better prevention and treatment.

Area of Science:

  • Obstetrics and Gynecology
  • Cardiovascular Health
  • Reproductive Medicine

Background:

  • Elevated pre-pregnancy blood pressure is linked to adverse pregnancy outcomes like placental abruption, preeclampsia, preterm birth, and fetal growth restriction.
  • These conditions, collectively termed placental syndromes, stem from impaired placentation and early placental vascularization.
  • Placental syndromes increase maternal risk for developing hypertension and cardiovascular disease (CVD) later in life, especially when combined with placental maternal vascular malperfusion (MVM).

Purpose of the Study:

  • To review the complex relationship between maternal blood pressure and pregnancy health.
  • To explore whether placental impairment contributes to or results from elevated blood pressure during pregnancy.
  • To highlight the need for comprehensive studies to resolve the causality between blood pressure and pregnancy complications.

Main Methods:

  • This is a review article, synthesizing existing research on blood pressure, placental syndromes, and long-term maternal cardiovascular health.
  • It examines the association between pre-pregnancy hypertension, placental syndromes, and maternal vascular malperfusion.
  • The review discusses the current understanding and gaps in knowledge regarding the etiological relationship.

Main Results:

  • Higher pre-pregnancy blood pressure is a significant risk factor for placental syndromes.
  • Placental syndromes are associated with an increased risk of future hypertension and CVD in women.
  • The causal relationship between placental dysfunction and maternal hypertension remains unclear.

Conclusions:

  • There is a critical need for longitudinal studies assessing cardiac and vascular structure/function before, during, and after pregnancy.
  • Such studies are essential to determine whether placental issues cause or are consequences of elevated blood pressure in women.
  • Findings will inform precision medicine approaches for preventing and treating placental syndromes and chronic hypertension in women.

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