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Offspring Outcomes After Maternal Hypertensive Disorder of Pregnancy

Maternal hypertensive disorder of pregnancy (HDP) is linked to increased risks of overall mortality and death from several specific conditions from birth to young adulthood, according to a national population-based cohort study from Denmark. Eclampsia and pre-eclampsia were associated with worse outcomes than hypertension alone.

The analysis included all 2.4 million individuals born in Denmark from 1978 through 2018. During follow-up over a median of 19.4 years, all-cause mortality rates were 58.94, 133.73, 44.35, and 41.99 per 100,000 person-years for those whose mothers had pre-eclampsia, eclampsia, hypertension, and no hypertension during pregnancy. “The difference in cumulative incidence in overall mortality between cohorts exposed and unexposed to maternal HDP was 0.37% (95% confidence interval 0.11% to 0.64%), and the population attributable fraction for maternal HDP was estimated as 1.09% (95% confidence interval 0.77% to 1.41%),” the authors write. “Maternal HDP was associated with a 26% (hazard ratio 1.26, 95% confidence interval 1.18 to 1.34) higher risk of all cause mortality in offspring. The corresponding estimates for maternal pre-eclampsia, eclampsia, and hypertension were 1.29 (1.20 to 1.38), 2.88 (1.79 to 4.63), and 1.12 (0.98 to 1.28). Increased risks were also observed for several cause specific mortalities, such as deaths from conditions originating in the perinatal period (2.04, 1.81 to 2.30), cardiovascular diseases (1.52, 1.08 to 2.13), digestive system diseases (2.09, 1.27 to 3.43), and endocrine, nutritional, and metabolic diseases (1.56, 1.08 to 2.27). The increased risks were more pronounced among offspring of mothers with early onset and severe pre-eclampsia (6.06, 5.35 to 6.86) or with both HDP and diabetes history (1.57, 1.16 to 2.14) or HDP and low education level (1.49, 1.34 to 1.66).”

Source: BMJ