# Association of Perinatal Cardiovascular Features with Angiotensin System Expressions in Maternal Preeclampsia

## TL;DR

This study shows that maternal preeclampsia affects the cardiovascular development and angiotensin system in newborns.

## Contribution

The study reveals new correlations between preeclampsia, angiotensin system expressions, and neonatal cardiovascular features.

## Key findings

- Neonates exposed to preeclampsia had larger coronary arteries and higher aminopeptidase-N levels.
- Preeclampsia cord plasma increased angiotensin receptor mRNA levels but decreased receptor protein in umbilical arteries.
- Angiotensin system expressions correlated with maternal and neonatal blood pressures and cardiac output.

## Abstract

We hypothesized and investigated whether prenatal exposure to preeclampsia (PE) would simultaneously affect perinatal cardiovascular features and angiotensin system expressions. This prospective study was composed of mother-neonate dyads with (n = 49) and without maternal preeclampsia (n = 48) in a single tertiary medical center. The neonates exposed to PE had significantly larger relative sizes for the left and right coronary arteries and a higher cord plasma level of aminopeptidase-N, which positively correlated with the maternal diastolic blood pressures and determined the relative sizes of the left and right coronary arteries, whereas the encoding aminopeptidase-N (ANPEP) mRNA level in the PE cord blood leukocytes was significantly decreased, positively correlated with the neonatal systolic blood pressures (SBPs), and negatively correlated with the cord plasma-induced endothelial vascular cell adhesion molecule-1 mRNA levels. The PE cord plasma significantly induced higher endothelial mRNA levels of angiotensin II type 1 receptor (AT1R) and AT4R, whereas in the umbilical arteries, the protein expressions of AT2R and AT4R were significantly decreased in the PE group. The endothelial AT1R mRNA level positively determined the maternal SBPs, and the AT4R mRNA level positively determined the neonatal chamber size and cardiac output. In conclusion, PE may influence perinatal angiotensin system and cardiovascular manifestations of neonates across placentae. Intriguing correlations between these two warrant further mechanistic investigation.