title: Fetal Endothelial Remodeling in Late-Onset Gestational Hypertension.
abstract: BACKGROUND
  Recent studies reveal that offspring of pregnancies complicated by hypertensive disorders may have an increased cardiovascular risk. Genetic and nongenetic factors seem to play an important role in premature arterial disease. Endothelium may be significant for long-term remodeling of the arterial wall. The aim of the study was to assess fetal endothelial and renal function in late-onset gestational hypertension.
  
  
  METHODS
  This was a case-controlled study. Singleton pregnancies affected by late-onset gestational hypertension (after 34 weeks' gestation) and controls were included. Ultrasound examinations (fetal biometry, fetal Doppler, fetal aorta intima media thickness (aIMT), fetal kidney volumes, maternal Doppler, presence of uterine arteries protodiastolic notching from anomaly scan) and clinical data were collected. A sample of amniotic fluid was taken at delivery.
  
  
  RESULTS
  Fifty patients with late-onset hypertension and 50 controls were included. At growth scan (weeks 29-32) we found in the study group significantly higher fetal aIMT, umbilical artery pulsatility index (PI), fetal aorta PI, and mean uterine arteries PI with persistent bilateral notch. In the case group microalbuminuria levels were significantly higher than controls (1.32±0.11 vs. 1.10±0.13g/l, P < 0.0001), and there was a negative correlation between renal fetal volume at growth scan and amniotic microalbuminuria (r: -0.95, 95% C -0.97 to -0.90, P < 0.0001).
  
  
  CONCLUSIONS
  Gestational hypertension should be considered as one of the adverse early risk factors that might predispose to impaired fetal cardiovascular development during intrauterine life; therefore, this study provides further evidence to better understand the origins of cardiovascular diseases.
authors.affiliation: Department of Woman's and Child's Health, Maternal Fetal Medicine Unit, University of Padua School of Medicine, Padua, Italy;
authors.forename: Silvia
authors.initials: S
authors.lastname: Visentin
authors.affiliation: Clinic of Obstetrics and Gynecology, DISM, University of Udine, Udine, Italy;
authors.forename: Ambrogio Pietro
authors.initials: AP
authors.lastname: Londero
authors.affiliation: Department of Woman's and Child's Health, Maternal Fetal Medicine Unit, University of Padua School of Medicine, Padua, Italy;
authors.forename: Beatrice
authors.initials: B
authors.lastname: Bellamio
authors.affiliation: Department of Woman's and Child's Health, Maternal Fetal Medicine Unit, University of Padua School of Medicine, Padua, Italy;
authors.forename: Grazia
authors.initials: G
authors.lastname: Giunta
authors.affiliation: Laboratory Medicine, University of Padua, Padua, Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: Cosma
authors.affiliation: Laboratory Medicine, University of Padua, Padua, Italy.
authors.forename: Diego
authors.initials: D
authors.lastname: Faggian
authors.affiliation: Laboratory Medicine, University of Padua, Padua, Italy.
authors.forename: Mario
authors.initials: M
authors.lastname: Plebani
authors.affiliation: Department of Woman's and Child's Health, Maternal Fetal Medicine Unit, University of Padua School of Medicine, Padua, Italy; ecosmi@hotmail.com.
authors.forename: Erich
authors.initials: E
authors.lastname: Cosmi
mesh_terms: D000328:Adult; D000418:Albumins / Q000032:analysis; D000653:Amniotic Fluid / Q000737:chemistry; D001158:Arteries / Q000000981:diagnostic imaging / Q000503:physiopathology*; D016022:Case-Control Studies; D004730:Endothelium, Vascular / Q000503:physiopathology*; D005260:Female; D005333:Fetus / Q000503:physiopathology*; D006801:Humans; D046110:Hypertension, Pregnancy-Induced / Q000000981:diagnostic imaging / Q000503:physiopathology*; D007668:Kidney / Q000000981:diagnostic imaging / Q000503:physiopathology; D021041:Placental Circulation; D011247:Pregnancy; D011673:Pulsatile Flow; D016216:Ultrasonography, Prenatal
chemical_list: D000418:Albumins
keywords: blood pressure; late onset hypertension; renal failure; vascular remodeling.