RESUMO
OBJECTIVE: To compare blood pressure (BP) in adolescence (11-12 years) among the offspring of preeclamptic and normotensive pregnancies. METHOD: SBP and DBP of 181 girls and boys born after pregnancies with preeclampsia were measured and compared with the BP of 356 age-matched girls and boys of normotensive pregnancies. The association of preeclampsia with later BP was adjusted for perinatal information, anthropometric factors at follow-up, and maternal BP and BMI. RESULTS: In the preeclampsia group, SBP in early adolescence was higher than in the normotensive group (115.3 vs. 113.5 mmHg, P = 0.03), but there was no difference in DBP (66.4 vs. 65.3 mmHg, P = 0.10). After adjustment for maternal body mass and BP, the difference in SBP was largely attenuated. CONCLUSION: The higher SBP among adolescent offspring of preeclamptic pregnancies could be mediated by maternal body mass or BP, factors that are positively associated with the risk of preeclampsia in pregnancy.
Assuntos
Pressão Sanguínea , Hipertensão/epidemiologia , Pré-Eclâmpsia/epidemiologia , Efeitos Tardios da Exposição Pré-Natal/epidemiologia , Adolescente , Estudos de Casos e Controles , Feminino , Seguimentos , Humanos , Masculino , Mães/estatística & dados numéricos , Gravidez , Fatores de Risco , Adulto JovemAssuntos
Benzimidazóis/efeitos adversos , Benzimidazóis/uso terapêutico , Morte Fetal/induzido quimicamente , Hipertensão/tratamento farmacológico , Oligo-Hidrâmnio/induzido quimicamente , Padrões de Prática Médica , Complicações Cardiovasculares na Gravidez/tratamento farmacológico , Tetrazóis/efeitos adversos , Tetrazóis/uso terapêutico , Adulto , Bloqueadores do Receptor Tipo 1 de Angiotensina II/efeitos adversos , Bloqueadores do Receptor Tipo 1 de Angiotensina II/uso terapêutico , Anti-Hipertensivos/uso terapêutico , Compostos de Bifenilo , Quimioterapia Combinada , Feminino , Humanos , Hidroclorotiazida/uso terapêutico , GravidezRESUMO
OBJECTIVE: To assess whether preeclampsia risk is elevated in pregnancies of diethylstilbestrol (DES)-exposed daughters. METHODS: This study used data from the National Cancer Institute DES Combined Cohorts Follow-up Study. A total of 285 preeclampsia cases (210 exposed and 75 unexposed) occurred in 7,313 live births (4,759 DES exposed and 2,554 unexposed). Poisson regression analysis estimated relative risks and 95% confidence intervals (CI) for preeclampsia adjusted for age at the index pregnancy, parity, education, smoking, body mass index, year of diagnosis, and cohort. RESULTS: In utero DES exposure was associated with nearly a 50% elevation in preeclampsia risk. Adjustment for preeclampsia risk factors attenuated the relative risk slightly (1.42, 95% CI 1.04-1.94). The excess risk with DES was concentrated among women who developed preeclampsia in their first pregnancies (relative risk 1.81, 95% CI 1.17-2.79), who were exposed before 15 weeks of gestation (relative risk 1.57, 95% CI 1.11-2.23), and who were treated with magnesium sulfate (relative risk 2.10, 95% CI 0.82-5.42). Among DES-exposed women who had a prior hysterosalpingogram, preeclampsia prevalence was higher in those with uterine abnormalities (12.4%) than in those without (7.7%). CONCLUSION: These data suggest that in utero exposure to DES is associated with a slightly elevated risk of preeclampsia, and that one possible biological mechanism involves uterine abnormalities.
