Hypertensive Disorders of Pregnancy and Fetal Growth Restriction: Clinical Characteristics and Placental Lesions and Possible Preventive Nutritional Targets
| Autor: | Daniela Denis Di Martino, Laura Avagliano, Enrico Ferrazzi, Federica Fusè, Vittoria Sterpi, Marco Parasiliti, Tamara Stampalija, Sara Zullino, Antonio Farina, Gaetano Pietro Bulfamante, Matteo Di Maso, Francesco D’Ambrosi |
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| Přispěvatelé: | Di Martino, Daniela Deni, Avagliano, Laura, Ferrazzi, Enrico, Fusè, Federica, Sterpi, Vittoria, Parasiliti, Marco, Stampalija, Tamara, Zullino, Sara, Farina, Antonio, Bulfamante, Gaetano Pietro, Di Maso, Matteo, D'Ambrosi, Francesco |
| Rok vydání: | 2022 |
| Předmět: |
Fetal Growth Retardation
Placenta Diseases Nutrition and Dietetics Placenta placenta pathology Hypertension Pregnancy-Induced fetal vascular malperfusion feto-placental Doppler maternal vascular malperfusion Mediterranean diet preeclampsia sFlt-1/PlGF ratio Pregnancy-Induced Case-Control Studies Female Humans Pregnancy Hypertension Case-Control Studie Human Food Science |
| Zdroj: | Nutrients; Volume 14; Issue 16; Pages: 3276 |
| ISSN: | 2072-6643 |
| Popis: | Background: The purpose of this study was to describe the placental lesions in pregnancies complicated by hypertensive disorders (HDP) and/or fetal growth restriction (FGR) and in uneventful control pregnancies. Methods: This is a case control study that included singleton pregnancies with HDP and normally grown fetus (HDP-AGA fetus), with HDP and FGR, early FGR, late FGR, and uneventful pregnancies. Feto-placental Doppler velocimetry and sFlt-1/PlGF ratio were performed. Placental histology was evaluated blinded according to the Amsterdam Consensus criteria. Results: Placental lesions with maternal vascular malperfusion (MVM) were significantly more frequent in HDP-FGR and early FGR (92% and 83%). MVM were significantly associated with abnormal feto-placental Doppler parameters, especially in early FGR. Delayed villous maturation (DVM) was associated with late FGR (83%). HDP-AGA fetus cases presented a heterogeneous pattern of placental lesions, including 60% of cases with MVM, but were not associated with abnormal Doppler feto-placental velocimetry. Conclusions: We found a prevalence of placental maternal vascular malperfusion in HDP-FGR and early FGR groups. These lesions were also associated with abnormal, anti-, and angiogenic markers. Conversely HDP-AGA fetus and late FGR presented more heterogeneous placental lesions not severe enough to cause feto-placental Doppler anomalies. These conditions are likely associated with different etiologies, such as maternal pre-pregnancy risk factors for metabolic syndrome. These findings suggest a possible preventive nutritional approach in addition to low-dose aspirin in pregnant women with predisposing factors for HDP-AGA fetuses and late FGR. |
| Databáze: | OpenAIRE |
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