Chronic inflammatory processes of the maternal genitourinary system, its role in cardiovascular diseases development in their children: Ukrainian and European experience of prevention as the key to the health of future generations

Abstract

Cardiovascular diseases (CVDs) remain the leading cause of morbidity in the world. The burden of CVDs continues to increase over the past decade in almost all countries of the world. The prevalence of CVDs in the world has almost doubled from 271 million i 1990 to 523 million in 2019. The number of deaths from CVDs over the same period has increased by twofold from 12.1 million to 18.6 million. The indicators of years of life with disability and lost years also doubled in total from 17.7 million in 1990 to 34.4 million in 2019. Data from Ukrainian and European statistics testify to the need for timely active measures aimed at preventing the development of CVDs. Modern strategies for the prevention of CVDs are primarily aimed at correcting the known risk factors: quitting smoking, regular physical exercise, normalizing body mass index, glucose, normalizing blood pressure, etc. What is not taken into account in this strategy? The very first periods of a human life, which significantly program health, duration and quality of life, remain beyond attention. In the structure of genital and extragenital pathology of women of reproductive age, significant parts are inflammatory diseases of the genitourinary system, which are characterized by predominantly chronic course. Simultaneous development of inflammatory diseases of the urinary and reproductive systems is explained by the facts that these systems organs develop from one primary germ layer (mesoderm), they have a close anatomical-physiological connection, a common blood supply and lymphatic system, and are also target organs of sex hormones activity. Babies born prematurely are at a greater risk of developing heart failure later in life. The incidence of heart failure in individuals born extremely prematurely (less than 28 weeks gestation) was 17.0 times higher compared to those born at term (37 weeks or more), after taking into account other factors. Similarly, those born very prematurely (28 to 31 weeks gestation) had an incidence of heart failure 3.58 times higher compared to term births. The analysis of the research results of Ukrainian and European scientists has shown that chronic inflammatory processes of the genitourinary system of the mother are a significant damaging factor that can change the morphological and functional state of the fetal and newborn cardiovascular system and cause the development of CVDs at various stages of ontogenesis. Thus, chronic inflammatory processes of the mother's genitourinary system are one of the factors that can cause the development of CVDs in children at different stages of ontogenesis. The classic concept of CVDs prevention should be supplemented taking into account the programming effect of harmful factors that act on the preconception and prenatal stages and reliably increase the risk of CDVs development. Among the reproduktive age, it is extremely necessary to carry out measures aimed at prevention, timely diagnostics and treatment of infectious and inflammatory diseases of the genitourinary system.