Maternal Hypertensive Disorders of Pregnancy and Cardiac Structure and Function in the Newborn

R Ottilia B Vøgg; Jørgen Vinsløv Hansen; Anne-Sophie Sillesen; Christian Pihl; Anna Axelsson Raja; Jonas Ghouse; Niels Vejlstrup; Kasper K Iversen; Henning Bundgaard; Heather A Boyd

doi:10.1016/j.jacadv.2022.100059

Maternal Hypertensive Disorders of Pregnancy and Cardiac Structure and Function in the Newborn

JACC Adv. 2022 Aug 26;1(3):100059. doi: 10.1016/j.jacadv.2022.100059. eCollection 2022 Aug.

Authors

R Ottilia B Vøgg^{1

2

3}, Jørgen Vinsløv Hansen², Anne-Sophie Sillesen¹, Christian Pihl¹, Anna Axelsson Raja³, Jonas Ghouse^{2

4

5}, Niels Vejlstrup³, Kasper K Iversen^{1

6}, Henning Bundgaard^{3

6}, Heather A Boyd²

Affiliations

¹ Department of Cardiology, Copenhagen University Hospital Herlev, Herlev, Denmark.
² Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark.
³ Department of Cardiology, The Heart Centre, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.
⁴ Laboratory for Molecular Cardiology, Department of Cardiology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
⁵ Laboratory for Molecular Cardiology, Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark.
⁶ Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.

Abstract

Background: Maternal hypertensive disorders of pregnancy (HDPs) are strongly associated with offspring congenital heart defects.

Objectives: This study assessed whether infants exposed to maternal HDPs were also more likely to have subtle cardiac structural and functional abnormalities than unexposed infants.

Methods: We used regression analyses to compare: 1) left ventricular parameters from conventional echocardiography performed in infants from the Copenhagen Baby Heart Study born to mothers with preeclampsia, gestational hypertension (GH), or no HDP; and 2) advanced echocardiographic parameters for 545 term infants born to mothers with preeclampsia and 545 matched infants not exposed to HDPs.

Results: Compared with infants unexposed to HDPs (n = 17,384), infants exposed to preeclampsia (n = 754) had a thicker interventricular septum in end-diastole (adjusted mean difference [± SD] 0.05 [±0.02] mm; P = 0.004), thicker left ventricular posterior wall (0.04 [±0.02] mm; P = 0.009), larger left ventricular internal diameter (0.12 [±0.06] mm; P = 0.04), and larger left ventricular volume (0.21 [±0.10] mL; P = 0.03). Systolic function changes included increased fractional shortening (0.36% [±0.14%]; P = 0.01) and stroke volume (0.18 [±0.07] mL; P = 0.006), whereas diastolic function changes included lower transmitral early peak inflow velocity (-1.76 [±0.49] mL; P = 0.0003), lower mitral annulus lateral wall a' (-0.21 [±0.09] cm/s; P = 0.02), and smaller lateral E/e' (-1.06 [±0.38] cm/s; P = 0.005). Conversely, there was little evidence of any association between maternal GH (n = 469) and offspring left ventricular parameters.

Conclusions: Maternal preeclampsia, but not GH, was associated with subtle newborn cardiac morphological and functional alterations, including thickening of the left ventricular myocardium and altered systolic and diastolic function.

Keywords: echocardiography; hypertensive disorders of pregnancy; infants; preeclampsia; risk factors.