Maternal preeclampsia and the risk of pediatric gastrointestinal diseases of the offspring: A population-based cohort study

Abstract

Objective: We aimed to study the long-term effect of preeclampsia on the risk for subsequent gastrointestinal morbidity of the offspring.

Study design: A population based cohort analysis comparing total and different subtypes of gastrointestinal related pediatric hospitalizations among offspring of preeclamptic mothers versus offspring of mothers without preeclampsia. The analysis included all singletons born between the years 1999-2014 at a single tertiary regional medical center. Gastrointestinal related morbidities included hospitalizations involving a set of ICD-9 codes, as recorded in hospital files. Infants with congenital malformations, multiple gestations, and perinatal deaths were excluded from the analysis. A Kaplan-Meier survival curve was used to compare the cumulative morbidity, and a Cox proportional hazards model was constructed to adjust for confounders.

Results: The study population included 239,687 newborns who met inclusion criteria; among them 2222 (0.93%) were born to mothers with severe preeclampsia or eclampsia, and 7279 (3.03%) were born to mothers with mild preeclampsia. Offspring of mothers with severe preeclampsia had significantly higher rates of gastrointestinal-related hospitalizations in comparison to offspring of mothers with mild preeclampsia and offspring of non-preeclamptic mothers (7.7% vs. 5.5% vs. 5.3%, respectively; p < 0.001). The association between exposure to severe preeclampsia and eclampsia and long-term gastrointestinal morbidity of the offspring remained significant and independent while adjusting for confounders (Adjusted HR = 1.2, 95% CI 1.0-1.4; p = 0.019).

Conclusion: Severe preeclampsia and eclampsia are independent risk factors for pediatric gastrointestinal morbidity of the offspring.

Keywords: Epigenetics; Hypertension; Intrauterine growth restriction.