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Preeclamptic pregnancies linked to increased CV risk factors in children
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Children and young adults born to pregnancies complicated by preeclampsia are at higher risk of increased blood pressure and BMI, according to study results.
Oxford University researchers performed a systematic review of 18 studies published between 1948 and 2011 that provided data on cardiovascular (CV) risk factors in children exposed to preeclampsia in utero. The researchers analyzed the lipid profile, blood pressure, glucose metabolism and BMI of 45,249 people. Those who were not exposed to preeclampsia were used as a control group.
In utero preeclampsia was associated with a 2.39 mm Hg higher systolic blood pressure (95% CI, 1.74-3.05) and a 1.35 mm Hg higher diastolic blood pressure (95% CI, 0.9-1.8) during childhood and young adulthood. Results also showed that BMI in those exposed to preeclampsia increased by 0.62.
“Associations were similar in children and adolescents, for different genders and with variation in birth weight,” the researchers said, adding that they found insufficient evidence to identify consistent variation in lipid profile or glucose metabolism.
A better understanding of the differences in blood pressure may provide insight into why some people are predisposed to hypertension and preeclampsia, according to the researchers.
“From a public health perspective, children born to a pregnancy complicated by preeclampsia appear to have a unique, lifetime cardiovascular risk profile that is present from early life, and so may constitute a population that may benefit from risk profile monitoring and early implementation of primary prevention strategies,” they wrote.
Disclosure: The researchers report no relevant financial disclosures.
Perspective
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Abigail Fraser, PhD, MPH
There is growing recognition that complications in pregnancy, including gestational diabetes, hypertensive disorders of pregnancy, preterm delivery and having a small gestational-age baby are associated with adverse maternal cardiometabolic health in later life. There is also accumulating evidence that pregnancy complications are associated with the same outcomes in the offspring in childhood and adolescence. This study systematically summarizes the evidence with regard to associations between preeclampsia, obesity and other cardiometabolic outcomes in the offspring. The authors combine the existing evidence and find that offspring of preeclamptic women have a higher mean BMI and blood pressure compared to offspring of non-preeclamptic women later in life.
Studies with data on cardiometabolic outcomes measured in the offspring in adulthood would be valuable in determining whether these associations persist. Also, the mechanism underlying the observed associations is still unclear. Is a shared environment (such as diet, exercise, etc), genetics or an intra-utero pathway in which exposure to preeclampsia results in adverse cardiometabolic health later in life responsible? Whether causal or not, pregnancy is a unique opportunity to identify women and offspring who are at increased risk of adverse cardiometabolic health later in life and, thus, for primordial prevention of these outcomes.
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