Pathophysiological events during pregnancy influence the development of atherosclerosis in humans

Pathophysiological events occurring during fetal development are increasing ly recognized as influencing atherosclerosis throughout childhood and adole scence. Maternal hypercholesterolemia during pregnancy markedly increases f atty streak formation in human fetal arteries. Although fetal fatty streaks partially regress under normocholesterolemic conditions, progression of at herosclerosis in children of hypercholesterolemic mothers is much faster th an in children of normocholesterolemic mothers. This cannot be accounted fo r by conventional risk factors of atherosclerosis or inherited genetic diff erences. The nature of the persistent changes in the fetal arterial wall re sponsible for increased atherogenesis in children and the mechanisms by whi ch maternal hypercholesterolemia induces these changes need to be investiga ted, because they may offer important insights into the pathogenesis of ath erosclerosis and because targeted interventions in mothers during pregnancy may yield considerable long-term benefits. (Trends Cardiovasc Med 1999;9:2 05-214). (C) 1999, Elsevier Science Inc.