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Pregnancy Induced Hypertension and Metabolic Disorders: from Pathophysiology to Clinical Consequences

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Hypertensive complications in pregnancy are a problem that has a significant impact on women's health since they are the main causes of maternal and fetal morbidity and mortality in developed countries. The most frequent hypertensive complication, which usually occurs after the 20th week of gestation, is ...

Hypertensive complications in pregnancy are a problem that has a significant impact on women's health since they are the main causes of maternal and fetal morbidity and mortality in developed countries. The most frequent hypertensive complication, which usually occurs after the 20th week of gestation, is preeclampsia, a condition characterized by high blood pressure associated with proteinuria not always accompanied by generalized edema. Often, the ineffective blood pressure control despite good therapy, the risk of cerebrovascular events or the evolution of preeclampsia towards more severe forms (malignant hypertension, HELLP syndrome, or eclampsia), make early delivery of baby the only possible solution.

Although the problem is widely known, there is still no clear evidence of causative factors and there are no effective preventive or treatment strategies. Early-onset preeclampsia, before 34th gestational week, has been associated mainly with placental abnormalities, whereas the late-onset form with maternal factors such as the metabolic syndrome. However, a distinction between the two forms with the relevant repercussions on newborns is just speculative and not clear clinical evidence has been proposed.

Hypertensive complications in pregnancy are a significant problem for the health of the newborn because of the high frequency of preterm births. Early birth remains one of the main causes of severe neonatal prematurity and development of child problems in the short and long term. Furthermore, preeclampsia is often associated with small newborns for gestational age with repercussions on the child's future health. Finally, numerous evidences are demonstrating how hypertensive complications in pregnancy are a true cardiovascular risk factor for the woman and her child. In fact, it has been seen that women with preeclampsia compared to women with healthy pregnancies of the same age are more likely to develop hypertension, dyslipidemia, diabetes mellitus and to manifest major cardio- and cerebrovascular events such as acute myocardial infarction and stroke. Similarly, children of mothers with pregnancy-induced hypertension are more prone to develop cardiovascular diseases and metabolic disorders later in life.

The aim of this Research Topic is to bring an update on the latest evidence regarding the hypertensive problems. Arguments may include studies or reviews on the epidemiology of the phenomenon, underlying pathophysiological and genetic mechanisms, maternal and fetal risk diagnostics, preventive and intensive treatment strategies, and preventive approaches for long-term cardiovascular treatment for women and children.

With this editorial project, we also want to raise awareness among health professionals who interact with a pregnant woman and her child about the hypertensive problem and doctors who follow women with complicated pregnancies or children born from complicated pregnancies to a careful follow-up of cardiovascular and metabolic risks over years.


Keywords: Adiposity, Epigenetics, Inflammation, Placental hormones, Metabolic syndrome


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