Professor and Chair UC San Diego Health La Jolla, CA, United States
Objective: The fetal in utero environment is known to affect health outcomes in childhood and beyond.Hypertensive disorders of pregnancy (HDP) are associated with uteroplacental ischemia, small for gestational age (SGA) newborns, and accelerated childhood growth.We evaluated whether HDP, in women at risk for late preterm delivery, were associated with altered growth in childhood.
Study Design: Secondary analysis of a prospective, follow-up study of children of mothers enrolled in a trial of late preterm steroids.To be eligible, children had to be ≥ 6 years old and have complete anthropometric measures. Participants with gestational hypertension, preeclampsia with or without severe features, HELLP or eclampsia at any time during pregnancy were considered to have a hypertensive disorder of pregnancy. Childhood height and weight were assessed at a study visit and BMI calculated.Z-scores were generated using the Centers for Disease Control and Prevention Growth Charts. Height, weight, and BMI z-score, along with measurements that were < 5th percentile or ≥ 95th percentile, were compared in children of mothers with or without a hypertensive disorder of pregnancy.Univariable and multivariable analyses were performed, the latter adjusting for pre-specified characteristics (Table).
Results: Of 2,422 eligible children, 1,026 were enrolled in the follow-up study and 1,020 were included in this analysis, of whom 353 (34.6%) had mothers with a HDP. Children in the hypertensive group were more likely to have been SGA at birth and their mothers were heavier and more likely to identify as White or Black race.There were no differences in the adjusted z-scores or the proportion < 5th percentile or ≥ 95th percentile for height, weight or BMI at the time of follow-up for children from pregnancies affected by hypertensive disorders (Table).
Conclusion: Hypertensive disorders of pregnancy in women at risk for late preterm delivery were associated with small for gestational age infants, but not childhood growth at 6 years of age.
