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Rev Bras Ginecol Obstet 2016; 38(08): 416-422
DOI: 10.1055/s-0036-1584515
Review Article
Thieme Publicações Ltda Rio de Janeiro, Brazil

Impacts of Preeclampsia on the Brain of the Offspring

Impactos da pré-eclâmpsia no cérebro de nascituros
Frances Dang
1   Department of Biomedical and Molecular Sciences, Queen's University, Kingston, ON, Canada
,
B Anne Croy
1   Department of Biomedical and Molecular Sciences, Queen's University, Kingston, ON, Canada
,
Patrick W. Stroman
2   Centre for Neuroscience Studies, Queen's University, Kingston, ON, Canada
,
Ernesto A. Figueiró-Filho
1   Department of Biomedical and Molecular Sciences, Queen's University, Kingston, ON, Canada
3   School of Medicine, Universidade Federal do Mato Grosso do Sul, FAMED-UFMS, Campo Grande, MS, Brazil
› Author Affiliations
Further Information

Publication History

24 March 2016

25 April 2016

Publication Date:
15 July 2016 (online)

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Abstract

Preeclampsia (PE) is a significant gestational disorder that causes complications in 3–5% of all human pregnancies. Apart from the immediate risks and complications for mother and fetus, both additionally carry elevated lifelong risks for specific complications. Offspring of PE pregnancies (PE-F1) have higher risks for hypertension, stroke and cognitive impairment compared with well-matched offspring (F1) from uncomplicated pregnancies. Prior to the clinical onset of PE, placental angiokines secreted into the maternal plasma are deviated. In many PE patients this includes deficits in placental growth factor (PGF). Our laboratory found that mice genetically-deleted for PGF (PGF − / − ) have altered cerebrovascular and brain neurological development detectable from midgestation to adulthood. We hypothesized that the PGF deficits seen in human PE, deviate fetal cerebrovascular and neurological development in a manner that impairs cognitive functions and elevates stroke risk. Here we summarize the initial analytical outcomes from a pilot study of 8–10 year old male and female PE-F1s and matched controls. Our studies were the first to report magnetic resonance imaging (MRI), magnetic resonance angiography (MRA) and functional brain region assessment by eye movement control and clinical psychometric testing in PE-F1s. Further studies in larger cohorts are essential to define whether there are image-based biomarkers that describe unique anatomical features in PE-F1 brains.

Resumo

A pré-eclampsia (PE) é importante doença gravídica complicando 3–5% de todas as gestações humanas. Além dos riscos imediatos e complicações para a mãe e o feto, a PE associa-se a outros riscos materno-fetais elevados em longo prazo. Nascituros de gestações complicadas por PE (PE-F1) apresentam maiores riscos de desenvolver hipertensão, acidente vascular cerebral e disfunção cognitiva em comparação com prole (F1) de gestações sem complicações. Antes do aparecimento clínico da PE, angiocitocinas placentárias secretadas no plasma materno apresentam-se alteradas. Em muitos pacientes com PE, isso inclui valores plasmáticos reduzidos de Fator de Crescimento Placentário (PGF). Nosso laboratório identificou que camundongos geneticamente não produtores de PGF (PGF − / − ) apresentam alterações vasculares e de desenvolvimento cerebral detectáveis do período gestacional à idade adulta. Nossa hipótese é que os déficits de PGF identificados em mulheres que desenvolveram PE podem desviar o desenvolvimento neurológico e vascular cerebral fetal, de maneira a prejudicar funções cognitivas, elevando o risco de AVC. Aqui resumimos os resultados analíticos iniciais de um estudo piloto com crianças do sexo masculino e feminino de 8–10 anos de idade nascidas de mães que tiveram PE (PE-F1s) comparadas com crianças controle pareadas por idade e sexo. Nossos estudos são os primeiros a relatar a ressonância magnética (RNM), a angiorressonância e a avaliação funcional do cérebro pelo controle de movimento dos olhos e pelo teste clínico psicotécnico em PE-F1s. Estudos adicionais em coortes maiores são essenciais para definir se há biomarcadores com base em imagens que possam descrever características anatômicas únicas em cérebros de crianças PE-F1.

Keywords

preeclampsia - PGF - fetal brain - MRI - cognitive development

Palavras-chave

pré-eclâmpsia - PGF - cérebro fetal - RNM - desenvolvimento cognitivo
 

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