ESPE Abstracts (2019) 92 FC7.4

Metabolic Syndrome Features in Pre-Pubertal Children Born After Maternal Pre-Eclampsia

Sarah Goffin1, José Derraik1,2,3,4, Valentina Chiavaroli1,5, Janene Biggs1, Paul Hofman1, Katie Groom1, Wayne Cutfield1,2

1Liggins Institute, University of Auckland, Auckland, New Zealand. 2A Better Start - National Science Challenge, University of Auckland, Auckland, New Zealand. 3Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden. 4Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China. 5Neonatal Intensive Care Unit, Pescara Public Hospital, Pescara, Italy

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 4–10 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 x10-4•min-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.

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