Funding outcome

In Canada, 8-11% of births are among women of advanced maternal age (≥ 35 years at delivery). Older mothers have increased risk of pregnancy complications including high blood pressure and gestational diabetes and a higher lifelong risk of cardiovascular disease. Babies born of older mothers are also at a higher risk of congenital anomalies, being born preterm or small, or stillborn. Despite this epidemiological evidence, we do not know what causes this increased risk. Cardiovascular diseases are associated with an elevated fight or flight response, this may result in negative changes in the function of blood vessels, such as increase stiffness and high blood pressure. Interestingly, our previous data have shown that during healthy pregnancies the fight or flight response is elevated but the negative consequences in the blood vessels are blunted. This grant aims to understand why older pregnant women (>35 years) have impaired cardiovascular and neurovascular health, and worse pregnancy outcomes compared to young women. We hypothesized that in older pregnant women the increased fight or flight response is associated with arterial stiffness and high blood pressure, putting them at higher risk of developing complications such as gestational diabetes, high blood pressure and delivering preterm or small babies. Moreover, we think that these women are at higher risk of cardivoascular diseases later in life because the negative impact of the fight or flight response on their blood vessels will persist after pregnancy. It is relevant to understand what aspects of cardiovascular adaptation may and may not be impaired with advanced maternal age. This will critically guide appropriate design of future studies and interventional trials