Maternal C-reactive protein and developmental programming of atherosclerosis
Received 26 April 2007; accepted 14 November 2007.
Objective
Maternal hypercholesterolemia during pregnancy enhances the susceptibility to atherosclerosis in their offspring by oxidation-dependent mechanisms. The present study investigated whether maternal C-reactive protein (CRP) level, which is an indicator of inflammation and cardiovascular risk, or smoking, which enhances oxidative stress, predict the in utero programming of atherosclerosis.
Study Design
Subsets of patients from the Fate of Early Lesions in Childhood study (156 normocholesterolemic children) were examined at autopsy, classified by maternal cholesterol levels during pregnancy. Maternal CRP level was correlated with maternal cholesterol and aortic atherosclerosis of children.
Results
CRP level was elevated in hypercholesterolemic mothers and showed significant correlation with atherogenesis in children in univariate and multivariate analysis. However, many hypercholesterolemic mothers did not have elevated CRP levels. Smoking only correlated in univariate analysis.
Conclusion
CRP level during pregnancy is a predictor of increased atherogenesis in children of hypercholesterolemic mothers, albeit a weaker one than maternal cholesterol. In the presence of hypercholesterolemia, maternal smoking does not further enhance atherogenic programming.
aRegional Hospital of Pellegrini and Loreto Crispi Hospital, 2nd School of Medicine, Federico II University, Naples, Italy
bDivision of Human Pathology, 2nd School of Medicine, Federico II University, Naples, Italy
cDivision of Obstetrics and Gynecology, Department of General Pathology and Excellence Research Center on Cardiovascular Diseases, 1st School of Medicine, II University of Naples, Naples, Italy
dDivision of Clinical Pathology, Department of General Pathology and Excellence Research Center on Cardiovascular Diseases, 1st School of Medicine, II University of Naples, Naples, Italy
eDepartment of Medicine, University of California, San Diego, School of Medicine, La Jolla, CA.
Reprints: Prof Claudio Napoli, Department of General Pathology, Division of Clinical Pathology and Excellence Research Center on Cardiovascular Diseases, 1st School of Medicine, II University of Naples, Complesso S. Andrea delle Dame 80138 Naples, Italy.
Cite this article as: Liguori A, D’Armiento FP, Palagiano A, Palinski W, Napoli C. Maternal C-reactive protein and developmental programming of atherosclerosis. Am J Obstet Gynecol 2008;198:281.e1-281.e5.
This study was supported by grants from the Regione Campania and Ministery of University and Research P.R.I.N. 2006 (C. N.) and National Institutes of Health grants HL067792 and HL56989 (C. N. and W.P.).