[Preeclampsia and pregnancy-induced hypertension - diseases determined in the uterus?].

Abstract

'Fetal programming' describes the association of alterations of the intrauterine fetal environment and the subsequent development of cardiovascular, metabolic and endocrine disorders in adult life. It is now commonly accepted that beside these so-called lifestyle disorders hypertensive disorders in pregnancy have also an intrauterine determination. It is commonly agreed that women born with low birth weight do have an elevated risk for the development of hyper-tensive pregnancy disorders, which is pronounced especially in those women born with low birth weight, who become obese in later life. Until now the exact pathophysiological mechanisms remain elusive: beside placental mechanisms intrauterine alterations in kidney development and insulin resistance seem to be major key factors. The pathophysiological similarities and risks of hypertensive pregnancy disorders (especially preeclampsia) and these 'lifestyle disorders' - both are also considered to be mutual risk factors for the development of the other disorder - suggest the possibility of a general impairment of the maternal cardiovascular system by intrauterine factors.