TY - JOUR
T1 - Maternal preeclampsia and long-term infectious morbidity in the offspring – A population based cohort analysis
AU - Rorman, Ella
AU - Freud, Amir
AU - Wainstock, Tamar
AU - Sheiner, Eyal
N1 - Publisher Copyright: © 2020 International Society for the Study of Hypertension in Pregnancy
PY - 2020/7/1
Y1 - 2020/7/1
N2 - Objective: We evaluated the association between maternal preeclampsia and long-term infectious morbidity of the offspring. Study design: A retrospective cohort analysis was performed, evaluating risk of long-term infectious morbidity in children born to women with and without preeclampsia between the years 1991–2014. Infectious morbidity included hospitalizations of offspring during childhood. Infants were followed until age 18 years or until hospitalization. Multiple gestations, newborns with congenital malformations and perinatal deaths were excluded. Cumulative incidence rates of infectious morbidity were compared. A Cox proportional hazards model was employed to control for various confounders including gestational age and cesarean delivery (CD). Results: During the study period 239,725 newborns were included: 96% (n = 230,217) without preeclampsia, 3% (n = 7280) with mild preeclampsia and 0.9% (n = 2228) with severe preeclampsia, defined mostly by evidence of maternal organ dysfunction. Hospitalization rate due to infectious morbidity was significantly higher for offspring to mothers with severe preeclampsia in comparison to those with no preeclampsia (13.1% vs 11%, P = 0.008), specifically respiratory and bacterial infections. The Kaplan-Meier survival curve demonstrated that offspring born to mothers with severe preeclampsia had a significantly higher cumulative incidence of hospitalization (Log-rank test P value = 0.026). However, while controlling for confounders in the Cox regression model, severe preeclampsia was not found as an independent risk factor (adjusted hazard ratio 0.95, 95% confidence interval 0.8–1.1, P = 0.36). Conclusion: While severe preeclampsia is associated with higher risk for long-term infectious morbidity of the offspring, it seems that the association is due to prematurity and CD, but not the preeclampsia per-se.
AB - Objective: We evaluated the association between maternal preeclampsia and long-term infectious morbidity of the offspring. Study design: A retrospective cohort analysis was performed, evaluating risk of long-term infectious morbidity in children born to women with and without preeclampsia between the years 1991–2014. Infectious morbidity included hospitalizations of offspring during childhood. Infants were followed until age 18 years or until hospitalization. Multiple gestations, newborns with congenital malformations and perinatal deaths were excluded. Cumulative incidence rates of infectious morbidity were compared. A Cox proportional hazards model was employed to control for various confounders including gestational age and cesarean delivery (CD). Results: During the study period 239,725 newborns were included: 96% (n = 230,217) without preeclampsia, 3% (n = 7280) with mild preeclampsia and 0.9% (n = 2228) with severe preeclampsia, defined mostly by evidence of maternal organ dysfunction. Hospitalization rate due to infectious morbidity was significantly higher for offspring to mothers with severe preeclampsia in comparison to those with no preeclampsia (13.1% vs 11%, P = 0.008), specifically respiratory and bacterial infections. The Kaplan-Meier survival curve demonstrated that offspring born to mothers with severe preeclampsia had a significantly higher cumulative incidence of hospitalization (Log-rank test P value = 0.026). However, while controlling for confounders in the Cox regression model, severe preeclampsia was not found as an independent risk factor (adjusted hazard ratio 0.95, 95% confidence interval 0.8–1.1, P = 0.36). Conclusion: While severe preeclampsia is associated with higher risk for long-term infectious morbidity of the offspring, it seems that the association is due to prematurity and CD, but not the preeclampsia per-se.
KW - Infectious morbidity
KW - Long-term
KW - Neonatal
KW - Preeclampsia
UR - http://www.scopus.com/inward/record.url?scp=85084051869&partnerID=8YFLogxK
U2 - https://doi.org/10.1016/j.preghy.2020.04.010
DO - https://doi.org/10.1016/j.preghy.2020.04.010
M3 - Article
C2 - 32371355
SN - 2210-7789
VL - 21
SP - 30
EP - 34
JO - Pregnancy Hypertension
JF - Pregnancy Hypertension
ER -