BACKGROUND: Elevated lipoprotein (Lp) (a) is the most common genetically determined risk factor found in babies with perinatal ischemic stroke. The influence of maternal Lp(a) has not been studied extensively to date. OBJECTIVES: To investigate the role of Lp(a) in our population of neonates with stroke. METHODS: In a prospective uncontrolled cohort of term-born children with neonatal arterial ischemic stroke, Lp(a) levels were investigated in 69 mothers and 69 children. Paternal Lp(a) was not explored. RESULTS: An increased Lp(a) level was found in 26 mothers [38%; 95% confidence interval (CI) 28-50%] and in 15 children (22%; 95% CI 13-33%). Both rates were higher than the reference range reported in the general Caucasian population (10% in adults and 5% in children). Additionally, there was a correlation between maternal and infantile Lp(a) levels (p < 0.0001) and between elevated maternal Lp(a) level and lower birth weight (p = 0.027). CONCLUSIONS: Elevated maternal Lp(a) is apparently a risk factor for neonatal arterial ischemic stroke. We speculate that the pathological mechanism of this relation may be mediated through a dysfunction of the placental vascularization.
BACKGROUND: Elevated lipoprotein (Lp) (a) is the most common genetically determined risk factor found in babies with perinatal ischemic stroke. The influence of maternal Lp(a) has not been studied extensively to date. OBJECTIVES: To investigate the role of Lp(a) in our population of neonates with stroke. METHODS: In a prospective uncontrolled cohort of term-born children with neonatal arterial ischemic stroke, Lp(a) levels were investigated in 69 mothers and 69 children. Paternal Lp(a) was not explored. RESULTS: An increased Lp(a) level was found in 26 mothers [38%; 95% confidence interval (CI) 28-50%] and in 15 children (22%; 95% CI 13-33%). Both rates were higher than the reference range reported in the general Caucasian population (10% in adults and 5% in children). Additionally, there was a correlation between maternal and infantile Lp(a) levels (p < 0.0001) and between elevated maternal Lp(a) level and lower birth weight (p = 0.027). CONCLUSIONS: Elevated maternal Lp(a) is apparently a risk factor for neonatal arterial ischemic stroke. We speculate that the pathological mechanism of this relation may be mediated through a dysfunction of the placental vascularization.
Authors: Neil A Goldenberg; Timothy J Bernard; Jasper Hillhouse; Jennifer Armstrong-Wells; Jeffrey Galinkin; Rhonda Knapp-Clevenger; Linda Jacobson; Santica M Marcovina; Marilyn J Manco-Johnson Journal: Haematologica Date: 2013-01-24 Impact factor: 9.941