Vascular Function in Women and Children Following a Pregnancy Complicated by Preeclampsia
preeclampsia , pregnancy , postpartum , vascular , endothelium
Preeclampsia is a severe hypertensive complication of pregnancy that poses significant maternal and fetal risk. Evidence suggests that preeclampsia is linked to later-life cardiovascular disease development in both mother and offspring. However, the mechanisms responsible for this phenomenon have not been determined, nor how they can be ameliorated. Non-invasive vascular assessment allows for the evaluation of subclinical indicators of cardiovascular risk. Herein we describe a series of studies which were undertaken to measure postpartum and offspring vascular functional alterations associated with preeclampsia in pregnancy and to improve the accuracy and clinical applicability of laser perfusion imaging. Our studies of postpartum women reveal that those with prior severe preeclampsia display heightened microvascular endothelium-dependent and -independent vasodilation and exhibit higher carotid stiffness compared to women with mild or no disease. In a small trial of offspring born to preeclamptic pregnancies, microvascular function does not appear to differ from uncomplicated counterparts, though recovery of perfusion after occlusion appears to occur faster. Finally, we describe the novel application of a computer vision modality to enable frame-by-frame segmentation of participant movement during a trial. Importantly, we demonstrate that a computer vision modality makes similar predictions to an experienced human rater in a fraction of the time. In short, the present data add to the growing understanding of postpartum mechanisms associated with preeclampsia which may predispose women to future disease, and the broad applications of perfusion imaging as a tool for measurement and disease surveillance.