Time from pre-eclampsia diagnosis to delivery affects future health prospects of children

Abstract

Background and objectives: Pre-eclampsia often has detrimental health effects for pregnant women and\rtheir fetuses, but whether exposure in the womb has long-term health-consequences for children as they\rgrow up remains poorly understood. We assessed overall morbidity of children following exposure to\reither mild or severe pre-eclampsia up to 30 years after birth and related disease risks to duration of\rexposure, i.e. the time from diagnosis to delivery.\rMethodology: We did a registry-based retrospective cohort study in Denmark covering the years 1979–\r2009, using the separate diagnoses of mild and severe pre-eclampsia and the duration of exposure as\rpredictor variables for specific and overall risks of later disease. We analysed 3 537 525 diagnoses for 14\rdisease groups, accumulated by 758 524 singleton children, after subdividing deliveries in six gestational\rage categories, partialing out effects of eight potentially confounding factors.\rResults: Exposure to mild pre-eclampsia appeared to have consistent negative effects on health later in\rlife, although only a few specific disease cases remained significant after corrections for multiple testing.\rMorbidity risks associated with mild pre-eclampsia were of similar magnitude as those associated with\rsevere pre-eclampsia. Apart from this overall trend in number of diagnoses incurred across disease\rgroups, hazard ratios for several disorders also increased with the duration of exposure, including\rdisorders related to the metabolic syndrome.\rConclusions and implications: Maternal pre-eclampsia has lasting effects on offspring health and differences\rbetween exposure to severe and mild pre-eclampsia appear to be less than previously\rassumed. Our results suggest that it would be prudent to include the long-term health prospects of\rchildren in the complex clinical management of mild pre-eclampsia.