The Association Between Maternal Preeclampsia and Risk for Offspring Infectious Diseases-A Sibling Matched Analysis
Dor Marciano1, Eyal Sheiner1, Ruslan Sergienko2
1Department of Obstetrics and Gynecology, Soroka University Medical Center, Beer-Sheva, Israel.
Insights
Children born to mothers with preeclampsia face a higher risk of long-term infectious diseases. Sibling analysis confirmed this increased risk, even after controlling for other factors.
Area of Science:
- Obstetrics and Gynecology
- Pediatric Health
- Epidemiology
Background:
- Preeclampsia affects 2%-5% of pregnancies globally, posing significant risks to maternal and fetal health.
- Maternal preeclampsia can have lasting impacts on offspring's immediate and long-term well-being.
- Previous studies on preeclampsia's long-term effects on offspring are limited by confounding factors.
Purpose of the Study:
- To investigate the association between maternal preeclampsia and long-term infectious morbidity in offspring.
- To utilize sibling-matched analysis for enhanced control of confounding variables.
Main Methods:
- A retrospective cohort study included women with preeclampsia in at least one pregnancy.
- Sibling-matched analysis compared offspring exposed and unexposed to maternal preeclampsia.
- Multivariable survival analysis assessed infectious hospitalization rates and time to first hospitalization.
Main Results:
- Offspring exposed to maternal preeclampsia (n=4272) showed a significantly higher risk of long-term infectious hospitalization compared to unexposed siblings (n=4272).
- The hazard ratio for infectious hospitalization was 1.324 (95% CI 1.168-1.503) after adjustments.
- Adjustments included maternal age, gestational age, and mode of delivery.
Conclusions:
- Pregnancies complicated by preeclampsia are associated with an increased risk of infectious morbidity in offspring.
- Sibling analysis strengthens the evidence, indicating a robust association even after rigorous confounder adjustment.
Background:
Preeclampsia is a severe, multisystem complication that affects 2%-5% of pregnancies, and is a leading cause of fetal and maternal morbidity and mortality worldwide. Preeclampsia may have devastating results on maternal health and may affect offspring's immediate and long-term health. Previous studies have examined the impact of maternal preeclampsia on the long-term health outcomes of offspring, many of these studies have been limited by confounding factors that could bias the results. The classic way of analyzing the relationship between maternal preeclampsia and long-term infectious morbidity of the offspring, which typically involves comparing the rates of infectious disease hospitalization between the exposed and unexposed groups, may not be sufficient due to the potential influence of unmeasured confounding factors.
Objective:
To study the association between maternal preeclampsia and long-term offspring infectious morbidity, while employing sibling-matched analysis to maximize confounder control.
Study Design:
A retrospective cohort was conducted, including parous women, who were diagnosed with preeclampsia in one pregnancy. A sibling-matched analysis was performed, so that one sibling was, and the other was not, prenatally exposed to maternal preeclampsia. Incidence of the offspring hospitalization with infectious morbidities were compared between the siblings, as well as the time to first hospitalization with such a diagnosis. Multivariable survival analysis was performed to adjust for confounding variables.
Results:
Offspring of mothers with preeclampsia (n = 4272) were significantly (p < 0.001) at a higher risk for long-term infectious hospitalization compared to offspring of mothers without preeclampsia (n = 4272), with a hazard ratio of 1.324 (95% CI 1.168-1.503) after adjusting for maternal age, gestational age, and mode of delivery.
Conclusions:
Offspring born following pregnancies complicated with preeclampsia are at increased risk for infectious morbidity, even while rigorously adjusting for confounders in a sibling analysis.
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