Is preeclampsia associated with fetal malformation? A review and report of original research

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Abstract

Objective: To examine fetal malformations in mother-infant pairs with and without pregnancy-related hypertension.Methods: This was an observational, population-based study of women delivering a singleton at our hospital. Specific fetal malformations identified in women with gestational hypertension or preeclampsia were compared to those without pregnancy-related hypertension. Women with chronic hypertension, superimposed preeclampsia on chronic hypertension and pregestational diabetes were excluded.Results: Between March 2002 and December 2012, a total of 151 997 women delivered, and 10 492 (7%) had preeclampsia, 4282 (3%) had gestational hypertension and 137 223 (90%) were referent normotensive controls. Women with preeclampsia were significantly more likely to deliver infants with malformations when compared to normotensive controls (2.5% versus 1.6%, p < 0.001), whereas women with gestational hypertension were not (1.9% versus 1.6%, p = 0.16). The overall risk for fetal malformation associated with preeclampsia remained significant following logistic regression for age, race, parity and maternal body-habitus (adjusted OR 1.5; 95% CI: 1.3-1.7). Only single-organ system malformations - microcephaly and hypospadias - remained associated with preeclampsia (p < 0.001), and fetal growth restriction was a co-factor for both.Conclusions: Preeclampsia was associated with increased rates of fetal malformations when compared to normotensive women - specifically microcephaly and hypospadias. These associations appear predominantly as a consequence of impaired fetal growth.

Original languageEnglish (US)
Pages (from-to)2135-2140
Number of pages6
JournalJournal of Maternal-Fetal and Neonatal Medicine
Volume28
Issue number18
DOIs
StatePublished - Dec 12 2015

Fingerprint

Pre-Eclampsia
Pregnancy Induced Hypertension
Research
Hypertension
Microcephaly
Hypospadias
Fetal Development
Mothers
Pregnancy
Parity
Logistic Models
Population

Keywords

  • Fetal malformation
  • gestational hypertension
  • preeclampsia

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Obstetrics and Gynecology

Cite this

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title = "Is preeclampsia associated with fetal malformation? A review and report of original research",
abstract = "Objective: To examine fetal malformations in mother-infant pairs with and without pregnancy-related hypertension.Methods: This was an observational, population-based study of women delivering a singleton at our hospital. Specific fetal malformations identified in women with gestational hypertension or preeclampsia were compared to those without pregnancy-related hypertension. Women with chronic hypertension, superimposed preeclampsia on chronic hypertension and pregestational diabetes were excluded.Results: Between March 2002 and December 2012, a total of 151 997 women delivered, and 10 492 (7{\%}) had preeclampsia, 4282 (3{\%}) had gestational hypertension and 137 223 (90{\%}) were referent normotensive controls. Women with preeclampsia were significantly more likely to deliver infants with malformations when compared to normotensive controls (2.5{\%} versus 1.6{\%}, p < 0.001), whereas women with gestational hypertension were not (1.9{\%} versus 1.6{\%}, p = 0.16). The overall risk for fetal malformation associated with preeclampsia remained significant following logistic regression for age, race, parity and maternal body-habitus (adjusted OR 1.5; 95{\%} CI: 1.3-1.7). Only single-organ system malformations - microcephaly and hypospadias - remained associated with preeclampsia (p < 0.001), and fetal growth restriction was a co-factor for both.Conclusions: Preeclampsia was associated with increased rates of fetal malformations when compared to normotensive women - specifically microcephaly and hypospadias. These associations appear predominantly as a consequence of impaired fetal growth.",
keywords = "Fetal malformation, gestational hypertension, preeclampsia",
author = "Nelson, {David B.} and Chalak, {Lina F.} and McIntire, {Donald D.} and Leveno, {Kenneth J.}",
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doi = "10.3109/14767058.2014.980808",
language = "English (US)",
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AU - Nelson, David B.

AU - Chalak, Lina F.

AU - McIntire, Donald D.

AU - Leveno, Kenneth J.

PY - 2015/12/12

Y1 - 2015/12/12

N2 - Objective: To examine fetal malformations in mother-infant pairs with and without pregnancy-related hypertension.Methods: This was an observational, population-based study of women delivering a singleton at our hospital. Specific fetal malformations identified in women with gestational hypertension or preeclampsia were compared to those without pregnancy-related hypertension. Women with chronic hypertension, superimposed preeclampsia on chronic hypertension and pregestational diabetes were excluded.Results: Between March 2002 and December 2012, a total of 151 997 women delivered, and 10 492 (7%) had preeclampsia, 4282 (3%) had gestational hypertension and 137 223 (90%) were referent normotensive controls. Women with preeclampsia were significantly more likely to deliver infants with malformations when compared to normotensive controls (2.5% versus 1.6%, p < 0.001), whereas women with gestational hypertension were not (1.9% versus 1.6%, p = 0.16). The overall risk for fetal malformation associated with preeclampsia remained significant following logistic regression for age, race, parity and maternal body-habitus (adjusted OR 1.5; 95% CI: 1.3-1.7). Only single-organ system malformations - microcephaly and hypospadias - remained associated with preeclampsia (p < 0.001), and fetal growth restriction was a co-factor for both.Conclusions: Preeclampsia was associated with increased rates of fetal malformations when compared to normotensive women - specifically microcephaly and hypospadias. These associations appear predominantly as a consequence of impaired fetal growth.

AB - Objective: To examine fetal malformations in mother-infant pairs with and without pregnancy-related hypertension.Methods: This was an observational, population-based study of women delivering a singleton at our hospital. Specific fetal malformations identified in women with gestational hypertension or preeclampsia were compared to those without pregnancy-related hypertension. Women with chronic hypertension, superimposed preeclampsia on chronic hypertension and pregestational diabetes were excluded.Results: Between March 2002 and December 2012, a total of 151 997 women delivered, and 10 492 (7%) had preeclampsia, 4282 (3%) had gestational hypertension and 137 223 (90%) were referent normotensive controls. Women with preeclampsia were significantly more likely to deliver infants with malformations when compared to normotensive controls (2.5% versus 1.6%, p < 0.001), whereas women with gestational hypertension were not (1.9% versus 1.6%, p = 0.16). The overall risk for fetal malformation associated with preeclampsia remained significant following logistic regression for age, race, parity and maternal body-habitus (adjusted OR 1.5; 95% CI: 1.3-1.7). Only single-organ system malformations - microcephaly and hypospadias - remained associated with preeclampsia (p < 0.001), and fetal growth restriction was a co-factor for both.Conclusions: Preeclampsia was associated with increased rates of fetal malformations when compared to normotensive women - specifically microcephaly and hypospadias. These associations appear predominantly as a consequence of impaired fetal growth.

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