Preeclampsia is associated with adverse maternal health outcomes later in life. Vascular endothelial dysfunction has been previously described following preeclampsia. We hypothesized that microvascular endothelial dysfunction associated with preeclampsia persists postpartum and may identify those at greatest risk of future cardiovascular disease. The objective of this study was to examine postpartum microvascular endothelial function in women after a pregnancy complicated by preeclampsia. Women with previous preeclampsia (n=30) and normotensive controls (n=30) between 6 months and 5 years postpartum were recruited. Severity of preeclampsia (severe (n=16) and mild (n=14)) was determined by standardized chart review. Microvascular reactivity in the forearm was measured with laser speckle contrast imaging, coupled with iontophoresis; endothelium-dependent and -independent vasodilation was induced with 1% acetylcholine and sodium nitroprusside solutions, respectively. A post-occlusive reactive hyperemia test assessed vasodilatory response following three minutes of suprasystolic (200 mmHg) occlusion with a mechanized cuff. Women with prior severe preeclampsia exhibited significantly higher vasodilation to acetylcholine and sodium nitroprusside compared to controls (P<0.01; P=0.03) and prior mild preeclampsia (P=0.03; P<0.01). Neither the degree of post-occlusive reactive hyperemia (P=0.98), nor time to return halfway to baseline (OR=1.026 (0.612, 1.72); P=0.92), differed between preeclampsia and controls. In conclusion, severe preeclampsia is associated with heighticrovascular endothelium-dependent and -independent vasoreactivity. These changes, or a common antecedent, may be linked to postpartum alterations in vascular function that predispose women to disease after preeclampsia. Further investigation should identify the contributing mechanism and the degree to which it could be amenable to medical intervention.

中文翻译：

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严重先兆子痫后产后微血管功能改变

子痫前期与生命后期不良的母亲健康结局有关。先兆子痫后已经描述了血管内皮功能障碍。我们假设与子痫前期有关的微血管内皮功能障碍在产后持续存在，并可能确定那些将来患心血管疾病的风险最大。这项研究的目的是检查妊娠合并子痫前期妇女的产后微血管内皮功能。招募了在产后6个月至5年之间患有先兆子痫（n = 30）和血压正常对照（n = 30）的女性。先兆子痫的严重程度（严重（n = 16）和轻度（n = 14））通过标准化图表检查确定。前臂微血管反应性是通过激光散斑对比成像和离子电渗疗法测量的。分别用1％乙酰胆碱和硝普钠溶液诱导内皮依赖性和非依赖性血管舒张。闭塞后反应性充血试验评估了机械化袖带上收缩（200 mmHg）三分钟后的血管舒张反应。与对照组（P <0.01; P = 0.03）和轻度先兆子痫（P = 0.03; P <0.01）相比，既往有严重先兆子痫的女性对乙酰胆碱和硝普钠的血管舒张作用明显增强。子痫前期和对照组之间，闭塞后反应性充血的程度（P = 0.98）或中途恢复到基线的时间（OR = 1.026（0.612，1.72）； P = 0.92）均无差异。总之，严重的子痫前期与高度血管内皮依赖性和非依赖性血管反应性有关。这些变化或共同的前因，可能与产后血管功能改变有关，后者使妇女容易患先兆子痫。进一步的调查应确定其促成机制以及在何种程度上可以接受医学干预。