Pre-eclampsia may raise a fetus’s risk of heart disease in later life

Children and teenagers who were exposed to pre-eclampsia in the uterus may be more likely to have a stroke or develop coronary artery disease, but the overall risk remains low

By Carissa Wong

Children and teenagers who were exposed to pre-eclampsia in the uterus may be at a higher risk of stroke and heart disease. In a study of more than 8 million people, pre-eclampsia was linked to an up to 34 per cent higher risk of developing either condition by around 19 years old.

Preeclampsia is a pregnancy complication that is thought to occur due to a problem with the placenta. Symptoms include high blood pressure and protein in urine. Many cases are mild, however, pre-eclampsia can lead to severe outcomes if the condition isn’t monitored.

Previous studies suggest that children who were exposed to pre-eclampsia in the uterus tend to have higher blood pressure, but it was unclear whether this elevated blood pressure then leads to a higher risk of a stroke or coronary heart disease, when the heart’s blood and oxygen supply is limited.

To learn more, Fen Yang and her colleagues at the Karolinska Institute in Sweden analysed the health records of nearly 8.5 million people living in Finland, Denmark and Sweden. Of these, 190,000 had been prenatally exposed to pre-eclampsia, based on their mother’s pre-eclampsia diagnosis, while nearly 8.3 million people hadn’t been exposed to the condition. The participants’ records were analysed from birth to age 19, on average.

Overall, the number of stroke events and coronary heart disease diagnoses were very low. Nevertheless, the participants who were prenatally exposed to pre-eclampsia were 33 per cent more likely to develop coronary heart disease and 34 per cent more likely to have had a stroke by 19, on average, compared with the participants with no prenatal pre-eclampsia exposure.

“The results are very surprising as they show higher rates of heart attacks and stroke while the offspring are still only in the first few decades of their lives,” says Paul Leeson at the University of Oxford. “Health problems like these in the first decades of life are rare, but, because they are studying millions of patients, they have been able to identify associations between pre-eclampsia and these rare events.”

The researchers accounted for factors that can influence the risk of either a stroke, coronary heart disease or pre-eclampsia, such as the participants’ sex and their mothers’ diabetes status.

The potential risks of pre-eclampsia didn’t substantially differ when accounting for maternal body mass index, smoking status or family history of cardiovascular disease.

“As it is only an association, the best way of preventing the problems remains unknown and so our best approach remains careful observation of traditional risk factors,” says Leeson. These include monitoring those with pre-existing medical conditions during pregnancy or who have had pre-eclampsia in a previous pregnancy.

Journal reference: JAMA Network Open , DOI: 10.1001/jamanetworkopen.2022.42064