Background: Preeclampsia is a pregnancy complication that affects 2-5% of pregnancies and is a leading case of maternal and infant morbidity and mortality. Women who develop preeclampsia are at approximately twice the risk of developing cardiovascular disease (CVD) in later life. Emerging evidence also demonstrates that children born of preeclamptic pregnancies may also be at increased risk of CVD in adulthood. We aimed to examine evidence for increased CVD risk factors in children exposed to preeclampsia in utero.
Methods: We performed a systematic review and meta-analysis on studies reporting cardiovascular risk factors among offspring of preeclamptic pregnancies compared to offspring of non preeclamptic pregnancies. The following electronic databases were searched: PubMed, CINAHL, the Cochrane Library and EMBASE with an end of search date of December 01, 2017. Information was extracted on established CVD risk factors including blood pressure, lipid profile, blood glucose, fasting insulin, body mass index (BMI) and endothelial/microvascular function. The review protocol is registered in PROSPERO (CRD42017074322)
Results: Thirty six studies provided cumulated data on 53,029 individuals. In utero exposure to preeclampsia was associated with 5.17 mmHg (95% CI: 1.60 to 8.73) higher systolic and 4.06 mmHg (95% CI: 0.67 to 7.44) higher diastolic blood pressure and 0.36 kg/m2 (95% CI: 0.04 to 0.68) higher BMI, during childhood or young adulthood. Blood glucose, lipids and insulin levels were not significantly different between the two groups.
Conclusion: Offspring of preeclamptic pregnancies demonstrate risk factors for CVD during childhood and young adult life. Early screening of children born after preeclamptic pregnancies may identify those that require interventions or preventive strategies to reduce the risk of CVD in later life.