Neurological lesions of the mother and the fetus in preeclampsia – an overview of the literature

Q4 Medicine Revista Romana de Pediatrie Pub Date : 2022-11-30 DOI:10.37897/rjp.2022.s2.13
M. Ciocârlan, R. Bors, Maria Anghelache, Vlad Dima, M. Plotogea, V. Varlas
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Abstract

About 3-5% of pregnancies are complicated by preeclampsia (PE), a multisystem disorder of exact unknown etiology, characterized by new-onset hypertension (>140/90 mmHg), proteinuria, and/or evidence of organ dysfunction. Although it is not yet completely understood what causes PE, maternal and placental factors seem to be involved. Endothelial dysfunction, maternal vascular inflammation, and remodeling of spiral arteries during placentation seem to be the underlying mechanisms of this pregnancy-related disease. Acute PE neurological complications, such as eclamptic seizures, cerebral edema, and intracerebral hemorrhage, are responsible for more than 70% of maternal deaths. Furthermore, long-term complications, such as cognitive dysfunction, the elevated lifetime risk of cerebrovascular disease, and persistent white matter lesions increase the rate of PE-related maternal morbidity and mortality. Hypertensive disorders associated with pregnancy affect not only the mother but also the baby by restricting the supply of nutrients and oxygen to the fetus. This has been associated with impaired cognitive development in children, increased lifetime cerebrovascular, cardiovascular, and metabolic risk, low intelligence quotient (IQ) and mental development indices (MDI), and more depression symptoms later in life. This study aims to review the literature and synthesize available information about preeclampsia and its neurological consequences on both the mother and the fetus.
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神经病变的母亲和胎儿在先兆子痫-文献综述
约3-5%的妊娠合并先兆子痫(PE),这是一种病因不明的多系统疾病,以新发高血压(>140/90mmHg)、蛋白尿和/或器官功能障碍为特征。尽管目前还不完全清楚PE的病因,但母体和胎盘因素似乎也参与其中。内皮功能障碍、母体血管炎症和胎盘形成过程中螺旋动脉的重塑似乎是这种妊娠相关疾病的潜在机制。急性PE神经系统并发症,如子痫发作、脑水肿和脑出血,是造成70%以上孕产妇死亡的原因。此外,长期并发症,如认知功能障碍、终身脑血管疾病风险升高和持续性白质病变,会增加PE相关孕产妇的发病率和死亡率。与妊娠相关的高血压疾病通过限制胎儿的营养和氧气供应,不仅影响母亲,也影响婴儿。这与儿童认知发展受损、一生脑血管、心血管和代谢风险增加、智商(IQ)和心理发展指数(MDI)低以及晚年更多的抑郁症状有关。本研究旨在回顾文献,综合有关先兆子痫及其对母亲和胎儿的神经影响的现有信息。
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来源期刊
CiteScore
0.10
自引率
0.00%
发文量
15
审稿时长
4 weeks
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