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Chapter 14 - The Role of Hormones in Hypertensive Disorders of Pregnancy

from Section II - Hormones and Gestational Disorders

Published online by Cambridge University Press:  09 November 2022

By
Leslie Myatt  and
James M. Roberts
Edited by
Felice Petraglia ,
Mariarosaria Di Tommaso  and
Federico Mecacci
Felice Petraglia
Affiliation:
Università degli Studi, Florence
Mariarosaria Di Tommaso
Affiliation:
Università degli Studi, Florence
Federico Mecacci
Affiliation:
Università degli Studi, Florence
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Summary

Hypertensive disorders of pregnancy including preeclampsia affect 5–7 percent of pregnancies and cause significant morbidity and mortality. The effects extend beyond pregnancy, being associated with increased risk of later life cardiovascular disease in the mother and programming of cardio-metabolic disease in the offspring. The profound changes in maternal metabolic and cardiovascular systems during pregnancy are mediated by altered production of hormones from the ovary, heart, brain, pineal gland, adrenal gland, and thyroid together with production and release of steroid and peptide hormones from the placenta. Production of these hormones is altered in hypertensive pregnancies, but distinction of cause from effect has been difficult to determine. Recent attention has focused on altered placental production of pro- and anti-angiogenic factors that may damage both the vasculature and renal systems. Although there is still debate as to the initiating factors for placenta dysfunction, syncytiotrophoblast stress has been postulated but without clear demonstration of cause versus effect.

Type
Chapter
Information
Hormones and Pregnancy
Basic Science and Clinical Implications
 , pp. 151 - 163
Publisher: Cambridge University Press
Print publication year: 2022

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