Presented at a symposium in honour of Lawrie Beilin held in conjunction with the High Blood Pressure Research Council of Australia Annual Scientific Meeting, Melbourne, 6–7 December 2005. The papers in these proceedings have been peer reviewed.
PRE-ECLAMPSIA: CONTRIBUTION OF MATERNAL CONSTITUTIONAL FACTORS AND THE CONSEQUENCES FOR CARDIOVASCULAR HEALTH
Version of Record online: 10 AUG 2006
Clinical and Experimental Pharmacology and Physiology
Volume 33, Issue 9, pages 826–830, September 2006
How to Cite
Barden, A. (2006), PRE-ECLAMPSIA: CONTRIBUTION OF MATERNAL CONSTITUTIONAL FACTORS AND THE CONSEQUENCES FOR CARDIOVASCULAR HEALTH. Clinical and Experimental Pharmacology and Physiology, 33: 826–830. doi: 10.1111/j.1440-1681.2006.04448.x
- Issue online: 10 AUG 2006
- Version of Record online: 10 AUG 2006
- Received 18 December 2005; revision 16 March 2006; accepted 20 March 2006.
- endothelial function;
- metabolic syndrome;
- 1Pre-eclampsia is a serious complication of pregnancy that is potentially life threatening for both the mother and baby. It encompasses a number of abnormalities that may be present in other clinical conditions.
- 2A placenta is essential for the development of pre-eclampsia and can be important in the pathogenesis of pre-eclampsia. Normal pregnancy is associated with remodelling of the maternal spiral arteries, which deliver blood to the placental villous space. Remodelling involves invasion by placental cytotrophoblasts that cause the maternal spiral arteries to lose their smooth muscle and become capacitance vessels; this process, known as placentation, is complete by 20 weeks of pregnancy. Poor placentation is associated with small-for-gestational-age fetuses and some cases of pre-eclampsia. It is thought that poor placentation can result in a hypoxic placenta that releases ‘toxic substances’ into the maternal circulation, contributing to the maternal syndrome. A number of candidate ‘toxic substances’ have been proposed, but none is universally raised in pre-eclampsia.
- 3Although the placenta is necessary for the development of pre-eclampsia, the extent to which placental abnormalities contribute to the condition varies. It is becoming apparent that maternal constitutional factors may also be important in this syndrome. Underlying hypertension, diabetes and obesity strongly predispose to pre-eclampsia. However, a continuum of risk may exist for blood pressure, bodyweight, glucose and lipids, which, in combination with each other and some degree of placental abnormalities, may lead to the development of pre-eclampsia.
- 4The present review will focus on the maternal constitutional factors that define the metabolic syndrome and examine their contribution to pre-eclampsia and the long-term consequences for cardiovascular health.