High blood pressure during pregnancy is known to affect the health of a mother and her unborn child, but new research shows that the association with increased overall mortality among the children extends from birth to adulthood.
Doctors have known that high blood pressure and various related conditions during pregnancy, including pre-eclampsia and eclampsia, are a leading cause of morbidity and mortality for the mother and child, affecting 10% of pregnancies worldwide.
Research has also shown that mothers who had pre-eclampsia, eclampsia or high blood pressure during pregnancy have an increased risk of later cardiovascular disease and death.
Now a new study shows that the risk for the child extends far into the child’s life, with the children of mothers who had pre-eclampsia, eclampsia or high blood pressure during pregnancy having an increased risk of death from birth to age 41 years, the age of the oldest children in the cohort investigated.
“In a 2021 study, we showed that pre-eclampsia, eclampsia or high blood pressure increase the child’s risk of cardiovascular disease. Other studies have shown that they are also associated with several conditions later in the child’s life, including metabolic syndrome, immune diseases and neurodevelopmental and mental disorders. However, evidence on how pre-eclampsia, eclampsia or high blood pressure affect the children’s long-term mortality from birth to adolescence was lacking,” explains a researcher behind the study, Jiong Li, Associate Professor, Department of Clinical Medicine, Aarhus University.
The research has been published in the British Medical Journal.
More than 40 years of follow-up
The researchers obtained data on 2,437,718 people born in Denmark from 1978 to 2018 to improve understanding of the association between pre-eclampsia, eclampsia and high blood pressure and the child’s risk of death.
The people were followed until the end of 2018, when the oldest children were 41 years old. The average follow-up was 19.4 years.
The researchers examined data on mothers: whether they had had pre-eclampsia, eclampsia or high blood pressure during pregnancy and whether their children had died during the follow-up period and the cause of death.
The researchers then compared the causes of death between children of mothers with pre-eclampsia, eclampsia or high blood pressure and the children of other mothers.
During pregnancy, 67,683 mothers had been diagnosed with pre-eclampsia, 679 with eclampsia and 33,733 with high blood pressure, total 102,095.
“Why some women develop these conditions and others do not is unclear, but many factors affect this, including pre-existing conditions such as diabetes, kidney disease or rheumatoid arthritis or a history of pre-eclampsia during previous pregnancies,” says Jiong Li.
Noticeable excess mortality
The results primarily show differences in the risk of dying among the children of mothers with the various conditions.
During the study period, 781 children of mothers with pre-eclampsia died (59 per 100,000 person-years), 17 children of mothers with eclampsia (134 deaths per 100,000 person-years) and 223 children of mothers with hypertension (44 deaths per 100,000 person-years).
A total of 19,119 children of mothers without pre-eclampsia, eclampsia or high blood pressure died (42 per 100,000 person-years).
Overall, people whose mothers had pre-eclampsia, eclampsia or high blood pressure during pregnancy had a 26% higher risk of death during the follow-up period compared with other people.
The mortality risk was 12% higher among the children of mothers with high blood pressure during pregnancy, 29% higher for pre-eclampsia and 188% higher for eclampsia.
The increased risk especially applied to deaths related to conditions originating in the perinatal period; cardiovascular diseases; digestive system diseases; and endocrine, nutritional and metabolic diseases.
The study also revealed that the risk was more pronounced among children of mothers with an early diagnosis of pre-eclampsia or severe pre-eclampsia, with the risk being nearly six times higher. A diagnosis of pre-eclampsia, eclampsia or high blood pressure and a history of diabetes was also associated with increased risk, as was the mother having a low education level.
“Our study provides useful information for doctors and decision-makers about mothers’ health during pregnancy. It can also help to increase awareness of these conditions among the general population and thereby improve understanding,” explains Jiong Li.
Women should pay attention to their child’s health
Jiong Li says that women should pay particular attention to their blood pressure during pregnancy and start with early treatment and monitoring.
In addition, doctors should monitor the children of mothers with pre-eclampsia, eclampsia or high blood pressure during pregnancy more closely and implement measures that can reduce their increased mortality risk.
“Women with severe pre-eclampsia, eclampsia or high blood pressure and women with one of these and a history of diabetes or low education before pregnancy should pay more attention to their child’s health,” concludes Jiong Li.