Cardiovascular dysfunction in children exposed to preeclampsia during fetal life

Abstract

Objective: Keeping in view the Developmental Origin of Health and Disease hypothesis, this study aimed to assess differences in cardiac and vascular structure and function in children exposed to preeclampsia in-utero as compared to those of normotensive mothers. We hypothesized that children exposed to preeclampsia had altered cardiac and vascular structure and function as compared to the unexposed group.Methods: This was a retrospective cohort study which included children between 2-10 years of age born to mothers with and without exposure to preeclampsia in-utero (n= 80 in each group). Myocardial morphology and function using echocardiogram and carotid intima-media thickness and pulse wave velocity were performed. Multivariable linear regression was used to compare preeclampsia exposed and non-exposed groups. Subgroup analysis to assess differences between early vs late onset preeclampsia was also performed.Results: Forty one percent (n=33) mothers had early onset preeclampsia. Children in the exposed group had significantly higher prevalence of Stage 1 systolic and diastolic hypertension (22%, n=18 and 35%, n=18 respectively) as compared to the unexposed group (9%, n=7 and 19% n =15 respectively, p=0.01). Children in the exposed group also had higher pulse wave velocity as compared to unexposed group (0.42 +/- 0.1 vs 0.39 +/- 0.1, p=0.03). Subgroup analysis revealed that blood pressure and pulse wave velocity changes were primarily determined by early onset preeclampsia. There was no significant difference in cardiac morphology or systolic and diastolic function between the exposed and unexposed groups.Conclusion: In-utero exposure to preeclampsia has an effect on the vascular function in children aged 2-10 years, primarily related to early onset disease. Routine blood pressure screening should be recommended for such children