About this Research Topic
Hypertensive disorders of pregnancy, comprising preeclampsia/eclampsia, gestational hypertension, chronic hypertension and preeclampsia superimposed on chronic hypertension, affect 10% of all pregnancies and are a major cause of maternal, fetal, neonatal and childhood morbidity and mortality.
Of these, preeclampsia is the commonest, corresponding to 50% of all hypertension during pregnancy and 15 % to all premature births. Recent reports indicate that the incidence of preeclampsia is increasing as a result of changing maternal characteristics such as age and pre-pregnancy weight. Although a disease of pregnancy, preeclampsia adversely affects every stage of human life, from the fetus to the adult.
The true etiology of preeclampsia is unknown, although theories abound. Preeclampsia is considered a two-stage disease where abnormal placentation leads to a hypo-perfused and hypoxic placenta which produces circulating factors affecting maternal endothelium leading to manifestations of the disease. These circulating factors include anti-angiogenic factors, inflammatory cytokines and oxidative stress factors. Preeclampsia, by definition, is onset of hypertension and proteinuria at or after twenty weeks of gestation. However, this antiangiogenic and inflammatory state exists even in the first trimester of pregnancy, before maternal symptoms appear. The fetus is thus exposed to this hypoxic, antiangiogenic and inflammatory in-utero environment from very early pregnancy and is at risk of aberrant development of almost any organ system. Maternal effects of preeclampsia both during pregnancy and in the long term are well reported. The same is not true of off springs of mothers with preeclampsia, with relatively limited data on their short- and long-term outcomes. Both clinical and mechanistic studies are needed to identify infants of preeclamptic mothers at risk of adverse outcomes.
This will help generate data for early prediction, identification, prevention and treatment of this vulnerable group of infants. Importantly, in the United States, the cost to the health care system related to preeclampsia is 2.1 billion dollars annually, most of it associated with adverse outcomes of off springs of mothers with preeclampsia.
The Research Topic will provide information to perinatologists, neonatologists and pediatricians about this unique group of infants and their short- and long-term outcomes. We welcome Original Research, Clinical Trials, Systematic Reviews and Meta-analysis and Mini-Reviews.
We will particularly focus on, but not limited to the following:
• Short term outcomes of preterm infants of mothers with preeclampsia. This may include respiratory outcomes such as respiratory distress syndrome and bronchopulmonary dysplasia, neurological outcomes like intraventricular hemorrhage and periventricular leukomalacia, retinopathy of prematurity, necrotizing enterocolitis and sepsis.
• Neurodevelopmental outcomes of infants of mothers with preeclampsia at 18 months, 3 and five years, including functional brain imaging studies.
• Cardiometabolic health of infants, children and adolescents of mothers with preeclampsia.
• Fetal growth and its association with outcomes.
• Basic science and mechanistic studies related to specific outcomes of infants of mothers with preeclampsia. This may include studies utilizing genomics, metabolomics or proteomics.
• Placental changes and pathology related to neonatal and infant outcomes of mothers with preeclampsia.
• Outcomes of infants of mothers with early onset preeclampsia (onset at < 34 weeks gestation) versus mothers with late onset preeclampsia (onset ≥ 34 weeks gestation).
We would like to acknowledge that Dr. Mariana Romanowski has acted as coordinator and have contributed to the preparation of the proposal for this Research Topic.
Of these, preeclampsia is the commonest, corresponding to 50% of all hypertension during pregnancy and 15 % to all premature births. Recent reports indicate that the incidence of preeclampsia is increasing as a result of changing maternal characteristics such as age and pre-pregnancy weight. Although a disease of pregnancy, preeclampsia adversely affects every stage of human life, from the fetus to the adult.
The true etiology of preeclampsia is unknown, although theories abound. Preeclampsia is considered a two-stage disease where abnormal placentation leads to a hypo-perfused and hypoxic placenta which produces circulating factors affecting maternal endothelium leading to manifestations of the disease. These circulating factors include anti-angiogenic factors, inflammatory cytokines and oxidative stress factors. Preeclampsia, by definition, is onset of hypertension and proteinuria at or after twenty weeks of gestation. However, this antiangiogenic and inflammatory state exists even in the first trimester of pregnancy, before maternal symptoms appear. The fetus is thus exposed to this hypoxic, antiangiogenic and inflammatory in-utero environment from very early pregnancy and is at risk of aberrant development of almost any organ system. Maternal effects of preeclampsia both during pregnancy and in the long term are well reported. The same is not true of off springs of mothers with preeclampsia, with relatively limited data on their short- and long-term outcomes. Both clinical and mechanistic studies are needed to identify infants of preeclamptic mothers at risk of adverse outcomes.
This will help generate data for early prediction, identification, prevention and treatment of this vulnerable group of infants. Importantly, in the United States, the cost to the health care system related to preeclampsia is 2.1 billion dollars annually, most of it associated with adverse outcomes of off springs of mothers with preeclampsia.
The Research Topic will provide information to perinatologists, neonatologists and pediatricians about this unique group of infants and their short- and long-term outcomes. We welcome Original Research, Clinical Trials, Systematic Reviews and Meta-analysis and Mini-Reviews.
We will particularly focus on, but not limited to the following:
• Short term outcomes of preterm infants of mothers with preeclampsia. This may include respiratory outcomes such as respiratory distress syndrome and bronchopulmonary dysplasia, neurological outcomes like intraventricular hemorrhage and periventricular leukomalacia, retinopathy of prematurity, necrotizing enterocolitis and sepsis.
• Neurodevelopmental outcomes of infants of mothers with preeclampsia at 18 months, 3 and five years, including functional brain imaging studies.
• Cardiometabolic health of infants, children and adolescents of mothers with preeclampsia.
• Fetal growth and its association with outcomes.
• Basic science and mechanistic studies related to specific outcomes of infants of mothers with preeclampsia. This may include studies utilizing genomics, metabolomics or proteomics.
• Placental changes and pathology related to neonatal and infant outcomes of mothers with preeclampsia.
• Outcomes of infants of mothers with early onset preeclampsia (onset at < 34 weeks gestation) versus mothers with late onset preeclampsia (onset ≥ 34 weeks gestation).
We would like to acknowledge that Dr. Mariana Romanowski has acted as coordinator and have contributed to the preparation of the proposal for this Research Topic.
Keywords: preeclampsia, preterm infants, pregnancy hypertension, eclampsia
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