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Early-onset preeclampsia may increase critical heart defect risk in offspring
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Women with preeclampsia during pregnancy are more likely to deliver an infant with a congenital heart defect, according to the results of a population-based study published in JAMA.
The researchers also found that although there was a low absolute risk for congenital heart defects, preeclampsia before 34 weeks was associated with critical heart defects.
Nathalie Auger, MD, MSc, FRCPC, and colleagues conducted a population-level analysis of live births in Quebec, Canada, between 1989 and 2012 (n = 1,942,072 neonates; 72,782 born to mothers with preeclampsia) to determine whether having preeclampsia during pregnancy is associated with giving birth to an infant with a congenital heart defect.
Auger, a researcher at the University of Montreal Hospital Research Centre and professor of social and preventive medicine at the University of Montreal, and colleagues found that infants born to mothers with preeclampsia had a higher absolute prevalence of congenital heart defects than those born to mothers without preeclampsia (16.7 per 1,000 vs. 8.6 per 1,000; prevalence ratio = 1.57; 95% CI, 1.48-1.67; prevalence difference, 577.1; 95% CI, 483-671.1).
The prevalence of noncritical heart defects also was higher in infants born to women with preeclampsia (1,538.8 per 100,000 vs. 789.2 per 100,000; prevalence ratio = 1.56; 95% CI, 1.47-1.67; prevalence difference, 521.1 per 100,000; 95% CI, 431.1-611), according to the researchers.
Overall, Auger and colleagues found, there was no significant difference in prevalence of critical heart defects based on whether the mother had preeclampsia (preeclampsia group, 123.7 per 100,000; no preeclampsia group, 75.6 per 100,000; prevalence ratio = 1.25; 95% CI, 1-1.57; prevalence difference, 23.6 per 100,000; 95% CI, ˗1 to 48.2).
However, compared with women who had preeclampsia at 34 weeks of pregnancy or later, those with preeclampsia earlier than 34 weeks had infants with a greater prevalence of critical heart defects (prevalence ratio = 2.78; 95% CI, 1.71-4.5; prevalence difference, 249.6 per 100,000; 95% CI, 89.7-409.6) and noncritical heart defects (prevalence ratio = 5.55; 95% CI, 4.98-6.19; prevalence difference, 6,089.2 per 100,000; 95% CI, 5,350-6,828.3), according to the researchers.
“Pregnant women with preeclampsia and infants born with heart defects have similarities in terms of the biological factors involved in the formation of blood vessels,” Auger said in a press release. “This coincidence in the imbalance of angiogenic factors prompted us to conduct this population-based study. Further research is needed before changing the medical recommendations. But knowing that preeclampsia can increase the risk of congenital heart defects in the unborn child should help us better understand the pathophysiology of these diseases and ultimately improve their prevention and treatment.” ˗ by Erik Swain
Disclosure: The researchers report no relevant financial disclosures.
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