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Pregnancy and cardiovascular disease

Fulvia Gloria-Bottini, Anna Neri, Luca Coppeta, Andrea Magrini, Egidio Bottini
OBJECTIVE: The birth weight/placental weight ratio has an important predictive value for perinatal mortality and morbidity and for cardiovascular diseases in adult life. In this study, we compared the birth weight/placental weight (BW/PW) ratio and the correlation between the two parameters in diabetic women with that observed in healthy women. MATERIALS AND METHODS: A total of 347 consecutive newborn infants from healthy puerperae, 164 newborns from puerperae with gestational diabetes, 148 newborns from puerperae with preexisting type 1 diabetes, and 40 newborns from puerperae with preexisting type 2 diabetes have been studied from the White population of Rome...
October 2016: Taiwanese Journal of Obstetrics & Gynecology
M L Mispireta, L E Caulfield, N Zavaleta, M Merialdi, D L Putnick, M H Bornstein, J A DiPietro
Zinc is an essential micronutrient for the development of the fetal renal, cardiovascular and metabolic systems; however, there is limited evidence of its effects on the postnatal cardiometabolic function. In this study, we evaluated the effect of maternal zinc supplementation during pregnancy on the cardiometabolic profile of the offspring in childhood. A total of 242 pregnant women were randomly assigned to receive a daily supplement containing iron+folic acid with or without zinc. A follow-up study was conducted when children of participating mothers were 4...
October 17, 2016: Journal of Developmental Origins of Health and Disease
Marc D Cohen, Edward Keystone
Rituximab is a chimeric monoclonal antibody directed at the CD20 molecule on the surfaces of some but not all B cells. It depletes almost all peripheral B cells, but other niches of B cells are variably depleted, including synovium. Its mechanism of action in rheumatoid arthritis (RA) is only partially understood. Rituximab was efficacious in clinical trials of patients with RA, including those who are methotrexate naïve, those with an incomplete response to methotrexate, and those with an incomplete response to tumor necrosis factor inhibitors...
December 2015: Rheumatol Ther
Chiara Sartori, Pietro Lazzeroni, Silvia Merli, Viviana Dora Patianna, Francesca Viaroli, Francesca Cirillo, Sergio Amarri, Maria Elisabeth Street
Adipokines are cytokines produced mainly by adipose tissue, besides many other tissues such as placenta, ovaries, peripheral-blood mononuclear cells, liver, muscle, kidney, heart, and bone marrow. Adipokines play a significant role in the metabolic syndrome and in cardiovascular diseases, have implications in regulating insulin sensitivity and inflammation, and have significant effects on growth and reproductive function. The objective of this review was to analyze the functions known today of adiponectin, leptin, resistin, and visfatin from placenta throughout childhood and adolescence...
2016: Mediators of Inflammation
Elisabeth Leirgul, Kristoffer Brodwall, Gottfried Greve, Stein E Vollset, Henrik Holmstrøm, Grethe S Tell, Nina Øyen
OBJECTIVE: To investigate the association between pregestational or gestational diabetes and offspring risk of congenital heart defects and the association between large-for-gestational-age birth weight and risk of cardiac defects in offspring of diabetic women. METHODS: Information on pregestational and gestational diabetes, cardiac defects, and birth weight among all births in Norway in 1994-2009 was ascertained from the Medical Birth Registry of Norway, national health registries, and the Cardiovascular Disease in Norway project...
October 6, 2016: Obstetrics and Gynecology
Sue Kildea, Sally Tracy, Juanita Sherwood, Fleur Magick-Dennis, Lesley Barclay
The well established disparities in health outcomes between Indigenous and non-Indigenous Australians include a significant and concerning higher incidence of preterm birth, low birth weight and newborn mortality. Chronic diseases (eg, diabetes, hypertension, cardiovascular and renal disease) that are prevalent in Indigenous Australian adults have their genesis in utero and in early life. Applying interventions during pregnancy and early life that aim to improve maternal and infant health is likely to have long lasting consequences, as recognised by Australia's National Maternity Services Plan (NMSP), which set out a 5-year vision for 2010-2015 that was endorsed by all governments (federal and state and territory)...
October 17, 2016: Medical Journal of Australia
H Gutiérrez-Leonard, E Martínez-Lara, A E Fierro-Macías, V M Mena-Burciaga, M D Ronquillo-Sánchez, E Floriano-Sánchez, N Cárdenas-Rodríguez
BACKGROUND: Cardiovascular disease is the leading cause of death in the Western world, and a major cause of this disease is atherosclerosis. Research has demonstrated that pregnancy-associated plasma protein A (PAPP-A) plays a role in cardiovascular disease, as evidenced by the association between PAPP-A and severity of heart damage. AIM: The aim of this work was to investigate the correlation between PAPP-A concentrations in coronary and peripheral blood and certain clinicopathological factors and antioxidant enzyme activities in patients diagnosed with coronary artery disease...
October 11, 2016: Irish Journal of Medical Science
K McCloskey, A-L Ponsonby, F Collier, K Allen, M L K Tang, J B Carlin, R Saffery, M R Skilton, M Cheung, S Ranganathan, T Dwyer, D Burgner, P Vuillermin
BACKGROUND: Excess adiposity and adiposity-related inflammation are known risk factors for cardiovascular disease in adults; however, little is known regarding the determinants of adiposity-related inflammation at birth. OBJECTIVES: The aim of this study was to investigate the association between maternal pre-pregnancy BMI and newborn adiposity and inflammation. METHODS: Paired maternal (28-week gestation) and infant (umbilical cord) blood samples were collected from a population-derived birth cohort (Barwon Infant Study, n = 1074)...
October 9, 2016: Pediatric Obesity
Konstantina Dipla, Areti Triantafyllou, Iris Grigoriadou, Evangelia Kintiraki, Georgios A Triantafyllou, Pavlos Poulios, Ioannis S Vrabas, Andreas Zafeiridis, Stella Douma, Dimitrios G Goulis
AIMS/HYPOTHESIS: Gestational diabetes mellitus (GDM) is a risk factor for the development of endothelial dysfunction and cardiovascular disease. However, in vivo microvascular endothelial function in GDM has not been investigated. This study aimed to examine, using near-infrared spectroscopy (NIRS), whether: (1) there are differences in microvascular reactivity and skeletal muscle oxygen consumption (m[Formula: see text]) at rest and during exercise between GDM and uncomplicated pregnancies; and (2) there is an association of NIRS indices with macrovascular function and cardiovascular disease risk factors...
October 8, 2016: Diabetologia
Sofia Klingberg, Hilde K Brekke, Anna Winkvist, Gunnar Engström, Bo Hedblad, Isabel Drake
BACKGROUND: High parity has been suggested to increase risk of maternal cardiovascular disease (CVD) independent of BMI measured after childbearing. Pregnancy is however associated with persistent weight gain and metabolic changes which all independent of parity increase the risk of CVD. It could therefore be questioned if high parity independently increases the risk of CVD or if this association may be confounded, mediated or modified by other parity-related factors. OBJECTIVE: To investigate the association between parity and risk of cardiovascular disease (CVD), and secondary outcomes in terms of myocardial infarction (MI) and cerebral infarction, with particular focus on potential mediation by anthropometric measures and effect-modification by lactation...
October 6, 2016: American Journal of Obstetrics and Gynecology
Helene McNulty, J J Strain, Catherine F Hughes, Mary Ward
Hypertension is the leading risk factor contributing to mortality worldwide, primarily from cardiovascular disease (CVD), while effective treatment of hypertension is proven to reduce CVD events. Along with the well recognized nutrition and lifestyle determinants, genetic factors are implicated in the development and progression of hypertension. In recent years genome-wide association studies have identified a region near the gene encoding the folate-metabolizing enzyme methylenetetrahydrofolate reductase (MTHFR) among eight loci associated with blood pressure...
October 6, 2016: Molecular Aspects of Medicine
Christina M Nowik, Jessica Pudwell, Graeme N Smith
OBJECTIVE: At Kingston General Hospital, women who have pregnancy-related cardiovascular risk indicators (e.g., preeclampsia, gestational hypertension, gestational diabetes) are offered standardized six-month postpartum follow-up for cardiovascular disease risk screening and counselling. We sought to assess how patient characteristics predict attendance at follow-up. METHODS: We undertook a chart review of 650 patients who delivered between April 2011 and December 2014 and had preeclampsia, gestational hypertension, or gestational diabetes...
October 2016: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
Tiina Vilmi-Kerälä, Outi Palomäki, Päivi Kankkunen, Leena Juurinen, Jukka Uotila, Ari Palomäki
INTRODUCTION: Gestational diabetes mellitus (GDM) is an indicator of future cardiovascular disease. We investigated if sensitive biomarkers of increased cardiovascular risk differ between women with and without a history of GDM few years after pregnancy, and whether obesity affects the results. MATERIAL AND METHODS: We studied two cohorts - 120 women with a history of GDM and 120 controls, on average 3.7 years after delivery. Circulating concentrations of oxidized low-density lipoprotein (oxLDL) were determined by ELISA...
September 28, 2016: Acta Obstetricia et Gynecologica Scandinavica
D Farsetti, D Lo Presti, I Pisani, G M Tiralongo, G Gagliardi, B Vasapollo, G P Novelli, H Valensise
INTRODUCTION: The purpose of our study was to evaluate the maternal haemodynamic profile in women diagnosed with threatened preterm delivery (TPD) in order to understand the possible pathophysiologic mechanism leading to an increased lifetime risk for future cardiovascular disease. METHODS: Sixty-eight patients diagnosed with TPD were enrolled and assessed using a non-invasive method (USCOM®) to determine the haemodynamic parameters. Cervix length assessment, vaginal and rectal swabs, blood inflammatory indexes, foetal vessel Doppler velocimetry, gestational age at the delivery and neonatal outcomes were considered...
August 2016: Journal of Maternal-fetal & Neonatal Medicine
Y Chow, M Wittwer, G Dekker, Clifton, V M Arstall
INTRODUCTION: Preeclampsia is associated with vascular dysfunction and long-term cardiovascular disease. A novel technique, TensioMed measuring Pulse Wave Velocity (PWV) and Augmentation index (Aix) to estimate arterial stiffness and vasoconstriction respectively during pregnancy and 6 months postpartum. Targets: Our aim was to evaluate vascular function during pregnancy and the postpartum period in women with preeclampsia compared to uncomplicated pregnancy. We evaluated 11 preeclampsia women, diagnosed with hypertension (4140/90 mmHg) and proteinuria (spot urine protein/creatine ratio 430 mg/mmol) and 7 women with uncomplicated pregnancy...
August 2016: Journal of Maternal-fetal & Neonatal Medicine
Dominika Szalewska, Magdalena Skrzypkowska
INTRODUCTION AND OBJECTIVES: Although physical activity has been found to reduce the risk of cardiovascular diseases and depression in the general population, little is known about physical patterns and the link with postnatal depressive symptoms and awareness of cardiovascular risk factors in postpartum women. The aim of this study was to examine physical activity patterns and their link to depressive symptoms in postpartum women. The secondary endpoint was the assessment of health awareness in women six months after delivery...
September 2016: Annals of Agricultural and Environmental Medicine: AAEM
Anouk Bokslag, Mirjam van Weissenbruch, Ben Willem Mol, Christianne J M de Groot
Preeclampsia is a common pregnancy specific disease, that presents with hypertension and a variety of organ failures, including malfunction of kidneys, liver and lungs. At present, the only definitive treatment of preeclampsia is end the pregnancy and deliver the neonate and placenta. For women with mild preeclampsia in the preterm phase of pregnancy, expectant management is generally indicated to improve fetal maturity, often requiring maternal medical treatment. Last decades, more evidence is available that the underlying mechanism of preeclampsia, endothelial disease, is not limited to pregnancy but increases cardiovascular risk in later life...
September 19, 2016: Early Human Development
Irena Odri Komazec, Anna Posod, Martin Schwienbacher, Maria Resch, Ulrike Pupp Peglow, Stefan Kiechl, Daniela Baumgartner, Ursula Kiechl-Kohlendorfer
OBJECTIVE: Preterm birth predisposes to the development of cardiovascular diseases in adulthood. The aim of this study was to characterize elastic properties of the aorta at preschool age and test the hypothesis that prematurity is associated with decreased aortic distensibility and increased stiffness, both of which are predictors of increased cardiovascular risk. APPROACH AND RESULTS: In an observational study of 76 five- to seven-year-old children born at a gestational age <32 weeks and 79 term-born controls, elastic parameters of the ascending and descending abdominal aorta were determined noninvasively by means of M mode echocardiographic tracings and calculated using computerized wall contour analysis...
September 22, 2016: Arteriosclerosis, Thrombosis, and Vascular Biology
Suzanne Oparil
Heart disease, stroke, and kidney failure are leading causes of death worldwide, and hypertension is a significant risk factor for each. Hypertension is less common in women, compared to men, in those younger than 45 years of age. This trend is reversed in those 65 years and older. In the US between 2011-2014, the prevalence of hypertension in women and men by age group was 6% vs 8% (18-39 years), 30% vs 35% (40-59 years), and 67% vs 63% (60 years and over). Awareness, treatment, and control rates differ between genders with women being more aware of their diagnosis (85% vs 80%), more likely to take their medications (81% vs 71%) and more frequently having controlled hypertension (55% vs 49%)...
September 2016: Journal of Hypertension
Satoshi Umemura
Primary aldosteronism (PA) is a heterogeneous group of disorders including both sporadic and familial forms (familial hyperaldosteronism type I, II and III). PA is the most frequent endocrine cause of secondary hypertension and associated with a higher rate of cardiovascular complications, compared with essential hypertension.Here I review the recent progress in understanding of the genetic and molecular mechanisms leading to autonomous aldosterone production in PA.Systematic screening detects primary aldosteronism in 5 to 10% of all patients with hypertension and in approximately 20% of patients with resistant hypertension...
September 2016: Journal of Hypertension
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