Health of children born to mothers who had preeclampsia: a population-based cohort study

Wu, Chunsen; Nøhr, Ellen Aagaard; Bech, Bodil Hammer; Vestergaard, Mogens; Catov, Janet M.; Olsen, Jørn

doi:10.1016/j.ajog.2009.06.060

Cited by 175 publications

(168 citation statements)

References 51 publications

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“…2 Recently, it has been observed that children exposed to preeclampsia are at an increased risk of a variety of diseases including endocrine, nutritional and metabolic diseases. 3 A recent study by Kajantie et al 4 using the Helsinki Birth Cohort Study found that preeclampsia was associated with increased risk of stroke and severe preeclampsia was associated with hypertension in an adult offspring 60-70 years after their birth. Several other studies also reported that the offspring of women who developed preeclampsia have higher BP in childhood [5][6][7] and adolescence.…”

Section: Introductionmentioning

confidence: 99%

Does hypertensive disorder of pregnancy predict offspring blood pressure at 21 years? Evidence from a birth cohort study

et al. 2011

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Although few studies found that the offspring of women who experienced preeclampsia have higher blood pressure (BP) at childhood and adolescence, no study has observed whether this association exists for adult offspring. To examine whether maternal hypertensive disorder of pregnancy (HDP) predicts adult offspring BP. We followed a sub-sample of 2608 mother-offspring pairs for 21 years from an original cohort of 7223 singleton infants whose mothers gave birth in Brisbane, Australia between 1981 and 1983. HDP was defined as diastolic BP (DBP) over 90 mm Hg on at least two occasions beyond 20 weeks gestation associated with proteinuria and/or excessive fluid retention. Adult offspring's systolic BP (SBP) and DBP were measured at 21 years. Multivariable regressions were used to examine the independent associations of HDP with offspring BP. Unadjusted regression analysis showed that offspring of women who experienced HDP have 3.46 mm Hg greater SBP and 3.02 mm Hg greater DBP at 21 years. This association remained consistent after adjusting for potential confounding and mediating factors including offspring gender, age, percentile birth weight for gestation, placenta weight and body mass index (BMI) at 21 year, maternal age, education, racial origin, and smoking during pregnancy and their pre-pregnancy BMI. Findings of this study suggest that maternal HDP predicts adult offspring BP. Keywords: hypertensive disorder of pregnancy; offspring blood pressure; young adults IntroductionWomen who develop hypertensive disorder of pregnancy (HDP) or preeclampsia are at an increased risk for high blood pressure (BP) and cardiovascular diseases later in life. 1 Also, men and women born after preeclampsia in pregnancies are likely to trigger severe preeclampsia in their own (or their partner's) pregnancy. 2 Recently, it has been observed that children exposed to preeclampsia are at an increased risk of a variety of diseases including endocrine, nutritional and metabolic diseases. 3 A recent study by Kajantie et al. 4 using the Helsinki Birth Cohort Study found that preeclampsia was associated with increased risk of stroke and severe preeclampsia was associated with hypertension in an adult offspring 60-70 years after their birth. Several other studies also reported that the offspring of women who developed preeclampsia have higher BP in childhood 5-7 and adolescence. [8][9][10][11] A recent meta-analysis also found that offspring of women with preeclampsia had higher levels of BP as compared with offspring from uneventful pregnancies. 12 Most of the studies have reported findings in children and adolescents but not in adults. Some studies have not adjusted for potential confounding or mediating factors such as maternal pre-pregnancy body mass index (BMI) 10 and maternal smoking during pregnancy. 8,11 It is unclear whether the observed associations are spurious or confounded with these factors. Using a long follow-up of a birth cohort study, we have the capacity to examine whether this association between HDP and offspring BP remai...

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Section: Introductionmentioning

confidence: 99%

Does hypertensive disorder of pregnancy predict offspring blood pressure at 21 years? Evidence from a birth cohort study

et al. 2011

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“…78 However, one large population-based cohort found no greater risk of future cardiovascular disease or insulin resistance in offspring of pre-eclamptic pregnancies when matched for birth weight and gestation compared with offspring of non-pre-eclamptic pregnancies. 79 Children born to pre-eclamptic pregnancies, especially those born at term, appear to be predisposed to inflammatory, endocrine and metabolic conditions, as well as being protected against cerebral palsy.…”

Section: Long-term Health Of Offspring Following Pre-eclampsiamentioning

confidence: 99%

Pre-eclampsia and long-term maternal health

Williams

2012

Obstet Med

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Summary: Pre-eclampsia is a syndrome of pregnancy, defined by the gestational-onset of hypertension and proteinuria, which resolves postpartum. This definition does not consider the variable multiorgan involvement of a syndrome that can include seizures, fulminating hepatic necrosis and a consumptive coagulopathy. These disparate clinical features are a consequence of an accelerated but transient metabolic syndrome with widespread maternal endothelial dysfunction and inflammation. A trigger to this maternal state is the relatively ischaemic placenta. As pregnancy progresses, the concentration of vaso-toxic factors released by the relatively ischaemic placenta gradually builds up in the maternal circulation. Those predisposed to endothelial dysfunction, e.g. women with risk factors for cardiovascular disease, are more sensitive to these placental derived factors and will develop preeclampsia before natural onset of labour. A woman's vulnerability to pre-eclampsia is therefore composed of a unique balance between her pre-existing maternal endothelial and metabolic health and the concentration of placental derived factors toxic to maternal endothelium. Delivery of the placenta remains the only cure.Years later, women who had pre-eclampsia are at increased risk of chronic hypertension, ischaemic heart disease, cerebrovascular disease, kidney disease, diabetes mellitus, thromboembolism, hypothyroidism and even impaired memory. This article describes how a brief, usually single episode of this acute pregnancy syndrome might both identify those vulnerable to chronic disease in later life and in some cases initiate chronic disease.

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“…Several studies indicate that PE is associated with a higher incidence of newborns with low birth weight (Groom et al, 2007;Duley, 2009;Wu et al, 2009). In addition, there's an increased incidence of newborns with low birth weight in pregnant women who developed PE at an earlier stage of pregnancy, compared with those who later developed PE (Xiong & Fraser, 2004;Groom et al, 2007).…”

Section: Preeclampsia Isshp Classificationmentioning

confidence: 99%

“…Prematurity is the leading cause of perinatal morbidity and mortality (Goldenberg et al, 2008) and PE is often associated with preterm delivery (Sibai et al, 2005;Goldenberg et al, 2008;Duley, 2009;Wu et al, 2009). Some neonatal complications resulting from PEc pregnancy are described, and are associated with prematurity, including jaundice, respiratory distress, apnea, seizures, hypoglycaemia and prolonged hospitalization (Duley, 2009;Wu et al, 2009). …”

Section: Preeclampsia Isshp Classificationmentioning

confidence: 99%