Pre-eclampsia babies have wider arteries

Infants born to mothers with pre-eclampsia exhibit a distinct coronary dilatation and endothelial inflammation at birth, a recent study has shown.

The researchers performed a combined observational cohort and case-control study, enrolling 65 neonates born to mothers with pre-eclampsia. Echocardiography was used to assess cardiovascular measurements upon admission, and the expression of the vascular cell adhesion molecule-1 (VCAM-1) was quantified in the umbilical arteries. A total of 404 controls of normotensive mothers were also included.

Pre-eclampsia infants showed significantly lower Apgar scores at 1 minute and birth weight (BW) than their normotensive comparators.

There were also important differences between groups in terms of arterial size. The left main coronary artery, for example, was significantly enlarged at birth in infants born to mothers with pre-eclampsia (median size, 1.36 vs 1.08 mm; p<0.001). The same was true for the right coronary artery (1.25 vs 1.0 mm; p<0.001).

On the other hand, the intraventricular septum was significantly thicker in normotensive infants (2.63 vs 2.40 mm; p<0.001).

Such differences in coronary sizes affected outcomes. In the entire pre-eclampsia group, a higher ratio value between the right main coronary artery size to the aortic root seemed to be predictive of postnatal death.

To determine mechanisms leading to coronary dilatation, the researchers looked at VCAM-1 expression in umbilical arteries. They found that tissues from the pre-eclampsia group were significantly enriched with the VCAM-1 protein than those in the normotensive group.

“[T]hese inter-relationships among endothelial VCAM-1, coronary size, and maternal BP may suggest the presence of certain substance(s) relating to BP regulation and/or pre-eclampsia severity from the maternal circulation or the placenta, which may lead to neonatal coronary dilatation and endothelial inflammation,” the researchers explained.