Preeclampsia and risk of maternal pulmonary hypertension at high altitude in Bolivia.
C E SalinasO V PateyC MurilloM GonzalesV EspinozaS MendozaR RuizR VargasY PerezJ MontañoL Toledo-JaldinA BadnerJ JimenezJ PeñarandaC RomeroM AguilarL RiverosI AranaDino A GiussaniPublished in: Journal of developmental origins of health and disease (2023)
Women with a history of preeclampsia (PE) have a greater risk of pulmonary arterial hypertension (PAH). In turn, pregnancy at high altitude is a risk factor for PE. However, whether women who develop PE during highland pregnancy are at risk of PAH before and after birth has not been investigated. We tested the hypothesis that during highland pregnancy, women who develop PE are at greater risk of PAH compared to women undergoing healthy highland pregnancies. The study was on 140 women in La Paz, Bolivia (3640m). Women undergoing healthy highland pregnancy were controls (C, n = 70; 29 ± 3.3 years old, mean±SD). Women diagnosed with PE were the experimental group (PE, n = 70, 31 ± 2 years old). Conventional (B- and M-mode, PW Doppler) and modern (pulsed wave tissue Doppler imaging) ultrasound were applied for cardiovascular íííassessment. Spirometry determined maternal lung function. Assessments occurred at 35 ± 4 weeks of pregnancy and 6 ± 0.3 weeks after birth. Relative to highland controls, highland PE women had enlarged right ventricular (RV) and right atrial chamber sizes, greater pulmonary artery dimensions and increased estimated RV contractility, pulmonary artery pressure and pulmonary vascular resistance. Highland PE women had lower values for peripheral oxygen saturation, forced expiratory flow and the bronchial permeability index. Differences remained 6 weeks after birth. Therefore, women who develop PE at high altitude are at greater risk of PAH before and long after birth. Hence, women with a history of PE at high altitude have an increased cardiovascular risk that transcends the systemic circulation to include the pulmonary vascular bed.
Keyphrases
- pregnancy outcomes
- pulmonary hypertension
- pulmonary artery
- pulmonary arterial hypertension
- polycystic ovary syndrome
- pregnant women
- coronary artery
- lung function
- gestational age
- cervical cancer screening
- breast cancer risk
- magnetic resonance imaging
- type diabetes
- high resolution
- early onset
- skeletal muscle
- body mass index
- intensive care unit
- chronic obstructive pulmonary disease
- physical activity
- computed tomography
- single molecule
- birth weight
- clinical evaluation
- endothelial cells
- mass spectrometry
- weight gain
- atomic force microscopy