A long-term study shows that excess risk lasts into adulthood.

Hypertensive disorders of pregnancy (HDP), encompassing hypertension, preeclampsia and eclampsia, are important causes of maternal and fetal morbidity and mortality. In children of affected women, hypertensive disorders of pregnancy have been associated with subsequent morbidity, including metabolic syndrome, immune diseases and neurodevelopmental and psychiatric disorders, but possible associations with mortality are unclear.

Using Danish health registries, investigators identified 2.4 million children born between 1978 and 2018, 4% of whom were exposed to hypertensive disorders of pregnancy. During 41 years of follow up, offspring exposed to hypertensive disorders of pregnancy had significantly higher mortality than children who were not exposed (adjusted hazard ratio, 1.26). Significant excess risk was observed for deaths due to conditions beginning perinatally and due to cardiovascular, digestive, endocrine, nutritional and metabolic diseases. Excess mortality was greatest shortly after birth but continued into childhood and adulthood.

Comment: The mechanisms of these associations are unclear but might involve unidentified consequences of disturbed placental function. Children exposed to hypertensive disorders of pregnancy and their families should be made aware of associated risks to their health and be monitored appropriately.
BRUCE SOLOWAY, MD
Associate Professor Emeritus of Family and Social Medicine, Albert Einstein College of Medicine, Bronx, New York, USA.

Huang C, et al. Maternal hypertensive disorder of pregnancy and mortality in offspring from birth to young adulthood: national population based cohort study. BMJ 2022; 379: e072157.

This summary is taken from the following Journal Watch title: Pediatrics and Adolescent Health Medicine.