Background: Pre-eclampsia is associated with important complications for both mother and baby in the short term, but there are limited data about its long-term effects on offspring metabolism. Thus, we aimed to assess whether maternal pre-eclampsia was associated with adverse effects on metabolism and body composition in the offspring in childhood.
Methods: We studied healthy pre-pubertal children (aged 410 years) born at term. Offspring of mothers who were diagnosed with pre-eclampsia (n=39) and offspring of mothers from control pregnancies (n=50) were compared. Primary outcome was insulin sensitivity measured using intravenous glucose tolerance tests and Bergman's minimal model. Other assessments included body composition using whole-body dual-energy x-ray absorptiometry, 24-hour ambulatory blood pressure monitoring and lipid profiles.
Results: Children born after maternal pre-eclampsia had lower insulin sensitivity compared to controls [9.86 vs 12.56 x10-4min-1(mU/l); P=0.046], as well as higher fasting insulin concentrations (5.64 vs 3.24 mIU/l; P<0.001) and HOMA-IR (1.18 vs 0.70; P=0.004). In addition, children born after pre-eclamptic pregnancies had higher diastolic blood pressure in the daytime (+4.6 mmHg; P=0.013) and night-time (+8.6 mmHG; P<0.0001), higher mean arterial pressure in the night-time (+7.0 mmHg; P<0.001), and lower nocturnal diastolic dipping (10.6 vs 16.2%; P=0.040), as well as higher triglyceride levels (0.75 vs 0.62 mmol/l; P=0.016). However, children in the two groups had similar anthropometry and body composition.
Conclusion: Our study shows for the first time that maternal pre-eclampsia is associated with lower insulin sensitivity and elevated fasting insulin levels in the pre-pubertal offspring. In addition, we observed abnormalities in 24-hour ambulatory blood pressure monitoring. As the aetiology of pre-eclampsia becomes clearer, relating these to childhood outcomes will be critical. Further studies are required to follow-up the offspring born after pre-eclampsia to ascertain whether the observed differences track into adolescence and adulthood.
19 - 21 Sep 2019
European Society for Paediatric Endocrinology