Preeclampsia may raise CV risks in offspring

Children born to women with preeclampsia may have increased cardiovascular (CV) risk factors early in life, a meta-analysis suggests. In utero exposure to preeclampsia was associated with higher systolic and diastolic blood pressure and body mass index (BMI) in childhood compared with unexposed children.

Women who develop preeclampsia are at risk for subsequent CV disease, and recent studies indicate that their offspring may be at risk as well. To further examine the implications for children exposed to preeclampsia in utero, researchers performed a systematic review and meta-analysis of 18 studies (45,249 patients) published between 1948 and 2011 that reported traditional CV risk factors in exposed children compared with controls.

When they extracted data about classic CV risk factors, including blood pressure, lipid profile, glucose metabolism, and BMI, the researchers found that children born to preeclamptic mothers had 2.39 mm Hg higher systolic blood pressure, 1.35 mm Hg higher diastolic blood pressure, and 0.62 kg/m2 greater BMI during childhood and young adulthood than did controls. The associations held for different sexes and birth weights. The meta-analysis did not find enough evidence to draw conclusions about the effect of maternal preeclampsia on lipids or glucose metabolism.

If the higher systolic blood pressure persists into adulthood, it would likely lead to an approximate 8% increase in the risk of death from ischemic heart disease and a 12% increase in risk of stroke, researchers say. The only long-term, follow-up study to date of mortality in children born to preeclamptic mothers reported a 1.9-fold increased risk of death from stroke.

Because preeclampsia causes fetal growth restriction, which is linked to higher blood pressure in adulthood, the researchers analyzed a subset of studies of term infants with mean birth weight greater than 2.5 kg. These babies also had increased systolic and diastolic blood pressure and BMI.

In light of the data, children of preeclamptic mothers may require intensive monitoring and primary prevention counseling related to cardiovascular risks, researchers say.

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