Hypertensive disorders of pregnancy and cardiometabolic outcomes in childhood: A systematic review.

Abstract

BackgroundHypertensive disorders of pregnancy (HDPs) are among the leading causes of maternal and perinatal morbidity and mortality worldwide and have been suggested to increase long-term cardiovascular disease risk in the offspring.ObjectiveThe objective of this study was to investigate whether HDPs are associated with cardiometabolic markers in childhood.Search strategyPubMed, The Cochrane Library and reference lists of included studies up to January 2019.Selection criteriaStudies comparing cardiometabolic markers in 2–18-year-old children of mothers with HDP in utero, to children of mothers without HDP.Data collection and analysisSixteen studies reported in 25 publications were included in this systematic review, of which three were considered as having high risk of bias. Thus 13 studies were included in the evidence synthesis: respectively two and eight reported pregnancy induced hypertension and preeclampsia, and three studies reported on both HDPs.Main resultsMost studies (n = 4/5) found a higher blood pressure in children exposed to pregnancy induced hypertension. Most studies (n = 7/10) found no statistically significantly higher blood pressure in children exposed to preeclampsia. No association was found between exposure to HDP and levels of cholesterol, triglycerides or glucose (n = 5/5). No studies investigated an association with (carotid) intima-media thickness, glycated haemoglobin or diabetes mellitus type 2.ConclusionsMost studies showed that exposure to pregnancy induced hypertension is associated with a higher offspring blood pressure. There is no convincing evidence for an association between exposure to preeclampsia and blood pressure in childhood. Based on current evidence, exposure to HDP is not associated with blood levels of cholesterol, triglycerides and glucose in childhood.