Impact of early- and late-onset preeclampsia on features of placental and newborn vascular health

Emilie M Herzog; Alex J Eggink; Anniek Reijnierse; Martina A M Kerkhof; Ronald R de Krijger; Anton J M Roks; Irwin K M Reiss; Alex L Nigg; Paul H C Eilers; Eric A P Steegers; Régine P M Steegers-Theunissen

doi:10.1016/j.placenta.2016.11.014

Impact of early- and late-onset preeclampsia on features of placental and newborn vascular health

Emilie M Herzog, Alex J Eggink, Anniek Reijnierse, Martina A M Kerkhof, Ronald R de Krijger, Anton J M Roks, Irwin K M Reiss, Alex L Nigg, Paul H C Eilers, Eric A P Steegers, Régine P M Steegers-Theunissen

Department of Pathology

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

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Abstract

INTRODUCTION: Offspring exposed to preeclampsia (PE) show an increased risk of cardiovascular disease in adulthood. We hypothesize that this is mediated by a disturbed vascular development of the placenta, umbilical cord and fetus. Therefore, we investigated associations between early-onset PE (EOPE), late-onset PE (LOPE) and features of placental and newborn vascular health.

METHODS: We performed a nested case-control study in The Rotterdam Periconceptional Cohort, including 30 PE pregnancies (15 EOPE, 15 LOPE) and 218 control pregnancies (164 uncomplicated controls, 54 complicated controls including 28 fetal growth restriction, 26 preterm birth) and assessed macroscopic and histomorphometric outcomes of the placenta and umbilical cord.

RESULTS: A significant association was observed between PE and a smaller umbilical vein area and wall thickness, independent of gestational age and birth weight. In EOPE we observed significant associations with a lower weight, length and width of the placenta, length of the umbilical cord, and thickness and wall area of the umbilical vein and artery. These associations attenuated after gestational age and birth weight adjustment. In LOPE a significant association with a larger placental width and smaller umbilical vein wall thickness was shown, independent of gestational age and birth weight.

DISCUSSION: Our study suggests that PE is associated with a smaller umbilical cord vein area and wall thickness, independent of gestational age and birth weight, which may serve as a proxy of disturbed cardiovascular development in the newborn. Follow-up studies are needed to ultimately predict and lower the risk of cardiovascular disease in offspring exposed to PE.

Original language	English
Pages (from-to)	72-79
Number of pages	8
Journal	Placenta
Volume	49
DOIs	https://doi.org/10.1016/j.placenta.2016.11.014
Publication status	Published - Jan 2017

Keywords

Placental dimensions
Cardiovascular disease
Preeclampsia
Umbilical cord vasculature
Vascular wall thickness

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10.1016/j.placenta.2016.11.014

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Herzog, E. M., Eggink, A. J., Reijnierse, A., Kerkhof, M. A. M., de Krijger, R. R., Roks, A. J. M., Reiss, I. K. M., Nigg, A. L., Eilers, P. H. C., Steegers, E. A. P., & Steegers-Theunissen, R. P. M. (2017). Impact of early- and late-onset preeclampsia on features of placental and newborn vascular health. Placenta, 49, 72-79. https://doi.org/10.1016/j.placenta.2016.11.014

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abstract = "INTRODUCTION: Offspring exposed to preeclampsia (PE) show an increased risk of cardiovascular disease in adulthood. We hypothesize that this is mediated by a disturbed vascular development of the placenta, umbilical cord and fetus. Therefore, we investigated associations between early-onset PE (EOPE), late-onset PE (LOPE) and features of placental and newborn vascular health.METHODS: We performed a nested case-control study in The Rotterdam Periconceptional Cohort, including 30 PE pregnancies (15 EOPE, 15 LOPE) and 218 control pregnancies (164 uncomplicated controls, 54 complicated controls including 28 fetal growth restriction, 26 preterm birth) and assessed macroscopic and histomorphometric outcomes of the placenta and umbilical cord.RESULTS: A significant association was observed between PE and a smaller umbilical vein area and wall thickness, independent of gestational age and birth weight. In EOPE we observed significant associations with a lower weight, length and width of the placenta, length of the umbilical cord, and thickness and wall area of the umbilical vein and artery. These associations attenuated after gestational age and birth weight adjustment. In LOPE a significant association with a larger placental width and smaller umbilical vein wall thickness was shown, independent of gestational age and birth weight.DISCUSSION: Our study suggests that PE is associated with a smaller umbilical cord vein area and wall thickness, independent of gestational age and birth weight, which may serve as a proxy of disturbed cardiovascular development in the newborn. Follow-up studies are needed to ultimately predict and lower the risk of cardiovascular disease in offspring exposed to PE.",

keywords = " Placental dimensions, Cardiovascular disease, Preeclampsia, Umbilical cord vasculature, Vascular wall thickness",

author = "Herzog, {Emilie M} and Eggink, {Alex J} and Anniek Reijnierse and Kerkhof, {Martina A M} and {de Krijger}, {Ronald R} and Roks, {Anton J M} and Reiss, {Irwin K M} and Nigg, {Alex L} and Eilers, {Paul H C} and Steegers, {Eric A P} and Steegers-Theunissen, {R{\'e}gine P M}",

note = "Publisher Copyright: {\textcopyright} 2016 The Authors",

year = "2017",

month = jan,

doi = "10.1016/j.placenta.2016.11.014",

language = "English",

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T1 - Impact of early- and late-onset preeclampsia on features of placental and newborn vascular health

AU - Herzog, Emilie M

AU - Eggink, Alex J

AU - Reijnierse, Anniek

AU - Kerkhof, Martina A M

AU - de Krijger, Ronald R

AU - Roks, Anton J M

AU - Reiss, Irwin K M

AU - Nigg, Alex L

AU - Eilers, Paul H C

AU - Steegers, Eric A P

AU - Steegers-Theunissen, Régine P M

PY - 2017/1

Y1 - 2017/1

N2 - INTRODUCTION: Offspring exposed to preeclampsia (PE) show an increased risk of cardiovascular disease in adulthood. We hypothesize that this is mediated by a disturbed vascular development of the placenta, umbilical cord and fetus. Therefore, we investigated associations between early-onset PE (EOPE), late-onset PE (LOPE) and features of placental and newborn vascular health.METHODS: We performed a nested case-control study in The Rotterdam Periconceptional Cohort, including 30 PE pregnancies (15 EOPE, 15 LOPE) and 218 control pregnancies (164 uncomplicated controls, 54 complicated controls including 28 fetal growth restriction, 26 preterm birth) and assessed macroscopic and histomorphometric outcomes of the placenta and umbilical cord.RESULTS: A significant association was observed between PE and a smaller umbilical vein area and wall thickness, independent of gestational age and birth weight. In EOPE we observed significant associations with a lower weight, length and width of the placenta, length of the umbilical cord, and thickness and wall area of the umbilical vein and artery. These associations attenuated after gestational age and birth weight adjustment. In LOPE a significant association with a larger placental width and smaller umbilical vein wall thickness was shown, independent of gestational age and birth weight.DISCUSSION: Our study suggests that PE is associated with a smaller umbilical cord vein area and wall thickness, independent of gestational age and birth weight, which may serve as a proxy of disturbed cardiovascular development in the newborn. Follow-up studies are needed to ultimately predict and lower the risk of cardiovascular disease in offspring exposed to PE.

AB - INTRODUCTION: Offspring exposed to preeclampsia (PE) show an increased risk of cardiovascular disease in adulthood. We hypothesize that this is mediated by a disturbed vascular development of the placenta, umbilical cord and fetus. Therefore, we investigated associations between early-onset PE (EOPE), late-onset PE (LOPE) and features of placental and newborn vascular health.METHODS: We performed a nested case-control study in The Rotterdam Periconceptional Cohort, including 30 PE pregnancies (15 EOPE, 15 LOPE) and 218 control pregnancies (164 uncomplicated controls, 54 complicated controls including 28 fetal growth restriction, 26 preterm birth) and assessed macroscopic and histomorphometric outcomes of the placenta and umbilical cord.RESULTS: A significant association was observed between PE and a smaller umbilical vein area and wall thickness, independent of gestational age and birth weight. In EOPE we observed significant associations with a lower weight, length and width of the placenta, length of the umbilical cord, and thickness and wall area of the umbilical vein and artery. These associations attenuated after gestational age and birth weight adjustment. In LOPE a significant association with a larger placental width and smaller umbilical vein wall thickness was shown, independent of gestational age and birth weight.DISCUSSION: Our study suggests that PE is associated with a smaller umbilical cord vein area and wall thickness, independent of gestational age and birth weight, which may serve as a proxy of disturbed cardiovascular development in the newborn. Follow-up studies are needed to ultimately predict and lower the risk of cardiovascular disease in offspring exposed to PE.

KW - Placental dimensions

KW - Cardiovascular disease

KW - Preeclampsia

KW - Umbilical cord vasculature

KW - Vascular wall thickness

U2 - 10.1016/j.placenta.2016.11.014

DO - 10.1016/j.placenta.2016.11.014

M3 - Article

C2 - 28012458

SN - 0143-4004

VL - 49

SP - 72

EP - 79

JO - Placenta

JF - Placenta

ER -

Impact of early- and late-onset preeclampsia on features of placental and newborn vascular health

Abstract

Keywords

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