Pre-eclampsia predicts later disease

EXPOSURE to pre-eclampsia in utero may lead to increased rates of disease and hospitalisation in later life, even if birth is at term, a study shows.

While previous studies have focused on short-term outcomes associated with pre-eclampsia, such as cerebral palsy, a large Danish study, which followed infants through to adulthood, found subjects remained at increased risk of a range of metabolic, endocrine and haematological diseases.

Pre-eclampsia was also associated with increased risk of hospitalisation for infectious and respiratory diseases.

The population-based cohort study of more than 1.6 million babies, followed for up to 27 years, also found an increased prevalence of congenital malformations of genital organs, especially among boys, in the babies exposed to pre-eclampsia.

“It is possible that pre-eclampsia and some congenital malformations may share common genetic or environmental factors,” the authors commented.

They found babies exposed to pre-eclampsia born at term were hospitalised more during childhood and the teen years compared to the non-exposed, whereas all preterm babies had similar hospitalisation rates regardless of pre-eclampsia status.

Dr Ted Weaver, president of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists, said the study backed the fetal origins of disease.

“It suggests that when you have a uterine environment hostile for a baby, such as when the placenta is not working properly .... that they develop abnormal coping mechanisms which may predispose them for disease later in life,” he said.

”It also may be that there is a link to whatever causes pre-eclampsia – that there’s a common disease origin for the conditions these kids have later in life.”

The findings from such a large study raised questions for further research, he said.

American Journal of Obstetrics & Gynecology 2009;201:269.e1-269.e10