Mitochondria-mediated Maternal-fetal Interactions and Consequences of Mitochondrial Dysregulation Indicate New Roles for Mitochondria in Hypertensive Pregnancies

Oxidative stress, placental mitochondrial morphological alterations, and impaired bioenergetics are associated with hypertensive disorders of pregnancy. Here we examined mitochondrial DNA mutational load in pregnant women with pregnancy-induced hypertension and reanalyzed publicly available high-throughput transcriptomic datasets from maternal and fetal tissues from normotensive and hypertensive pregnancies. Mitochondrial dysregulation was indicated by aberrant mitochondrial gene expression, and putative consequences were examined. Women with hypertensive pregnancy had elevated mitochondrial DNA mutational load. Maternal mitochondrial dysregulation in hypertensive pregnancies was associated with pathways involved in inflammation, cell death/survival, and placental development. In fetal tissues from hypertensive pregnancies, mitochondrial dysregulation was associated with increased extracellular vesicle production. Our study demonstrates mitochondria-mediated maternal-fetal interactions during healthy pregnancy and maternal mitochondrial dysregulation in hypertensive pregnancy development.

FEASIBILITY OF VASCULAR REMODELING PARAMETER ESTIMATION FOR ASSESSING HYPERTENSIVE PREGNANCY DISORDERS

Hypertensive pregnancy disorders, such as preeclampsia, are leading sources of both maternal and fetal morbidity in pregnancy. Non-invasive imaging, such as ultrasound and magnetic resonance imaging (MRI), is an important tool in predicting and monitoring these high risk pregnancies. While imaging can measure hemodynamic parameters, such as uterine artery pulsatility and resistivity indices, the interpretation of such metrics for disease assessment rely on ad-hoc standards, which provide limited insight to the physical mechanisms underlying the emergence of hypertensive pregnancy disorders. To provide meaningful interpretation of measured hemodynamic data in patients, advances in computational fluid dynamics can be brought to bear. In this work, we develop a patient-specific computational framework that combines Bayesian inference with a reduced-order fluid dynamics model to infer remodeling parameters, such as vascular resistance, compliance and vessel cross-sectional area, known to be related to the development of hypertension. The proposed framework enables the prediction of hemodynamic quantities of interest, such as pressure and velocity, directly from sparse and noisy MRI measurements. We illustrate the effectiveness of this approach in two systemic arterial network geometries: an aorta with carotid and a maternal pelvic arterial network. For both cases, the model can reconstruct the provided measurements and infer parameters of interest. In the case of the maternal pelvic arteries, the model can make a distinction between the pregnancies destined to develop hypertension and those that remain normotensive, expressed through the value range of the predicted absolute pressure.

Maternal Hypertensive Pregnancy Disorders and Mental and Behavioral Disorders in the Offspring: a Review

Purpose of Review We review here recent original research and meta-analytic evidence on the associations of maternal hypertensive pregnancy disorders and mental and behavioral disorders in the offspring. Recent Findings Seven meta-analyses and 11 of 16 original research studies published since 2015 showed significant associations between maternal hypertensive pregnancy disorders and offspring mental and behavioral disorders. Evidence was most consistent in meta-analyses and high-quality cohort studies. The associations, independent of familial confounding, were observed on different mental and behavioral disorders in childhood and schizophrenia in adulthood. Preterm birth and small-for-gestational age birth emerged as possible moderators and mediators of the associations. Cross-sectional and case-control studies yielded inconsistent findings, but had lower methodological quality. Summary Accumulating evidence from methodologically sound studies shows that maternal hypertensive pregnancy disorders are associated with an increased risk of mental and behavioral disorders in the offspring in childhood. More studies on adult mental disorders are needed.

Factors associated with hypertensive pregnancy syndrome: analysis multiple in hierarchical models / Fatores associados à síndrome hipertensiva da gestação: análise múltipla em modelos hierarquizados

Objetivo: analisar os fatores associados a Síndrome Hipertensiva da Gestação. Método: estudo transversal, observacional, do qual participaram 314 gestantes, realizado em um município do interior do Paraná. As variáveis foram agrupadas em níveis de maneira hierarquizada. O nível distal contemplou variáveis de caráter biológico; intermediário as características sociodemográficas e de estilo de vida; proximal as variáveis da assistência pré-natal. Realizou-se análise de regressão logística múltipla. Resultados: os fatores associados foram: obesidade e a doença crônica não transmissível, no nível distal; cuidados com a alimentação e recebimento de benefício social apresentaram associação no nível intermediário; no nível proximal, consulta com especialista, acompanhamento nutricional e obesidade gestacional. Doença crônica não transmissível, cuidados com a alimentação e acompanhamento nutricional demonstraram-se fatores protecionais. Conclusão: os fatores associados à SHG são amplos e abarcam aspectos que devem ser considerados não somente na assistência pré-natal, mas no cuidado à saúde da mulher em idade fértil.