%0 Journal Article
%T Preeclampsia Is a Biomarker for Vascular Disease in Both Mother and Child: The Need for a Medical Alert System
%A Julie Hakim
%A Mary K. Senterman
%A Antoine M. Hakim
%J International Journal of Pediatrics
%D 2013
%I Hindawi Publishing Corporation
%R 10.1155/2013/953150
%X This paper reviews the literature pertaining to the impact of preeclampsia not only on the mother but particularly on the children. The review points to the higher blood pressure in children born to preeclamptic mothers compared to controls, their increased tendency to suffer strokes, the reduction in their cognitive ability, and their vulnerability to depression. Mechanisms that may induce these changes are emphasized, particularly the placental vascular insufficiency and the resulting hypoxic and proinflammatory environments in which the fetus develops. The hypothesis proposed is that these changes in the fetal-placental environment result in epigenetic programming of the child towards a higher propensity for vascular disease. The review¡¯s main recommendation is that, within ethical boundaries, the medical records of individuals born to preeclamptic mothers should clearly indicate this event and should be made available to the affected individuals so that preventive measures against vascular complications and lifestyle changes that may mitigate the latter can be instituted. 1. Introduction Pregnancy is a transient condition, but when it is complicated by preeclampsia it has lasting effects on both the mother and the child. This paper describes the short- and long-term consequences of preeclampsia to both the mother and the child, with an emphasis on the children¡¯s vulnerability to vascular disease and cognitive impairment, and summarizes the potential pathophysiologic mechanisms at play. It also aims to expose the need to more easily identify individuals whose mothers were preeclamptic so that prevention measures can be instituted to avoid the vascular disease complications. The paper is the result of multiple literature searches through PubMed and other search engines spanning the period from 2000 to 2012. Preference was given to meta-analyses and large health surveys. The articles referenced in this paper were selected because they contributed to understanding the broader picture emerging on the importance of preeclampsia as a long-term threat to the health of the mother and the child. 2. Definition and Prevalence of Preeclampsia The American College of Obstetricians and Gynecologists defines preeclampsia as hypertension with a systolic blood pressure of 140£¿mm/Hg or higher or a diastolic blood pressure of 90£¿mm/Hg or higher that occurs after 20 weeks of gestation in a woman with previously normal blood pressure. The hypertension must be combined with proteinuria, defined as urinary excretion of 0.3£¿g protein or higher in a 24£¿h urine collection
%U http://www.hindawi.com/journals/ijpedi/2013/953150/