{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,4]],"date-time":"2025-12-04T16:07:13Z","timestamp":1764864433507,"version":"3.46.0"},"reference-count":65,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["ATVB"],"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>Evidence suggests that the intrauterine environment shapes offspring cardiovascular disease risk. Although placental dysfunction may be an important pathophysiologic pathway, numerous parental and pregnancy characteristics that influence offspring blood pressure are strong confounders of the mechanistic role of the placenta in observational analyses of singletons. Therefore, we leverage twin- and sibling-based comparison designs to determine whether placental pathology is associated with offspring blood pressure at age 7 while mitigating major sources of confounding.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>Data are from pregnant participants and their offspring in the Collaborative Perinatal Project, a longitudinal pregnancy cohort conducted from 1959 to 1965 in the United States. After delivery, placentas were systematically examined for lesions indicative of maternal vascular malperfusion (MVM) and acute inflammation. Blood pressure was assessed at a follow-up research visit when the offspring were 7 years old. Linear fixed-effects models were used to estimate associations between within-twin or sibling discordance in placental pathology and differences in blood pressure at age 7.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>\n                      Overall, 193 twin pairs were eligible for inclusion, and 23.3% had placentas discordant for MVM. In a fixed-effect analysis, a twin with high-grade MVM had a higher systolic blood pressure\n                      <jats:italic toggle=\"yes\">Z<\/jats:italic>\n                      score by 0.56 SDs than their co-twin without MVM (95% CI, 0.06\u20131.05) or a 5.7-mm\u2005Hg difference (95% CI, 0.6\u201310.8). Associations were consistent in a sensitivity analysis restricted to dichorionic twins and in a secondary analysis of 759 MVM-discordant sibling pairs. Acute placental inflammation was not associated with blood pressure at age 7.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>MVM in the placenta is associated with higher offspring blood pressure in mid-childhood, independent of parental and pregnancy characteristics that twins have in common. The findings support the role of the placenta and the intrauterine environment in the developmental origins of cardiovascular health.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/atvbaha.124.321666","type":"journal-article","created":{"date-parts":[[2024,12,19]],"date-time":"2024-12-19T05:00:40Z","timestamp":1734584440000},"page":"312-322","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Placental Pathology and Blood Pressure at Age 7: A Longitudinal Discordant Twin Analysis"],"prefix":"10.1161","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9745-7768","authenticated-orcid":true,"given":"Alexa A.","family":"Freedman","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, Endeavor Health, Evanston, IL (A.A.F.)."},{"name":"Now with Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL 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Gynecology, The University of Chicago Pritzker School of Medicine, Chicago, IL (L.S.K.-D., A.B.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8331-6419","authenticated-orcid":true,"given":"Stephen E.","family":"Gilman","sequence":"additional","affiliation":[{"name":"Social and Behavioral Sciences Branch, Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD (S.E.G.)."},{"name":"Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (S.E.G.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ann","family":"Borders","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology (L.S.K.-D., A.B.), Endeavor Health, Evanston, IL."},{"name":"Department of Obstetrics and Gynecology, The University of Chicago Pritzker School of Medicine, Chicago, IL (L.S.K.-D., 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