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Determinants of vascular structure and function in at-risk children born to mothers managed for pre-eclampsia
Michelle Renlund1,2, Tiina Jääskeläinen3,4, Anni Kivelä3
1Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
Insights
Children exposed to pre-eclampsia (PE) show normal peripheral artery intima-media thickness but associations with blood pressure. Adiposity links to carotid artery stiffness, suggesting early cardiovascular disease progression in PE-exposed children.
Area of Science:
- Pediatric Cardiology
- Vascular Biology
- Obstetrics
Background:
- Pre-eclampsia (PE) is linked to elevated blood pressure (BP) in children.
- Investigating the impact of PE on child arterial health is crucial for early cardiovascular disease detection.
Purpose of the Study:
- To determine if elevated BP in children exposed to PE is reflected in their arterial health.
- To examine the influence of anthropometrics, body composition, and perinatal factors on arterial health in children exposed to PE.
Main Methods:
- Prospective cohort study of 182 PE-exposed and 85 non-exposed children aged 8-12 years.
- Assessed arterial health using ultra-high-frequency ultrasound, ambulatory BP, body composition, and tonometry-derived pulse wave velocity (PWV).
Main Results:
- No differences in carotid artery intima-media thickness (IMT), adventitia thickness (AT), or lumen diameter (LD) between groups.
- Peripheral artery IMTs were associated with 24-h systolic BP and pulse pressure, PWV, and anthropometrics (lean body mass).
- Adiposity was independently associated with local carotid artery stiffness, distensibility, and wall stress.
Conclusions:
- Peripheral artery IMT in PE-exposed children is similar to controls but associated with BP.
- Adiposity correlates with carotid artery stiffness, indicating potential early cardiovascular disease progression in PE-exposed children.
- Gestational or perinatal factors did not show significant associations with child vascular health parameters.
Background And Aim:
Pre-eclampsia (PE) is related to elevated blood pressure (BP) in children. The study aims to investigate if elevated BP is reflected in child arterial health and how anthropometrics, body composition, and gestational and perinatal factors influenced this.
Methods:
In this prospective cohort study, we assessed the arteries of 182 children exposed (46 had an early onset, with a diagnosis before 34 gestational weeks, and 136 had a late onset) and 85 children unexposed (non-PE) to PE at 8-12 years from delivery using ultra-high-frequency ultrasound in addition to ambulatory and central BPs, body composition and anthropometrics, and tonometry-derived pulse wave velocity (PWV).
Results:
No differences were found in intima-media thickness (IMT), adventitia thickness (AT), lumen diameter (LD), local carotid artery stiffness, distensibility, or wall stress between PE-exposed and non-PE-exposed children. All children's brachial, radial, and femoral artery IMTs were associated with 24-h systolic BP (SBP) and pulse pressure, carotid-femoral PWV, and anthropometric measures. The 24-h SBP and anthropometrics, notably lean body mass, were independent predictors of peripheral artery IMTs (brachial R2 = 0.217, radial R2 = 0.208, femoral R2 = 0.214; p < 0.001). Head circumference predicted carotid artery IMT and LD (β = 0.163, p = 0.009; β = 0.417, p < 0.001, respectively), but carotid artery IMT was not associated with BP. No independent associations were found for peripheral artery ATs. Local carotid artery stiffness, distensibility, and wall stress were independently associated with adiposity. No significant associations were found between gestational or perinatal factors and child vascular health parameters.
Conclusions:
The peripheral artery IMT of PE-exposed children is identical to that of non-PE-exposed children, but associated with BP. Adiposity is related to local carotid artery stiffness. These adverse associations in arterial health may reflect the early progression of cardiovascular disease in PE-exposed children.
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