Fetal Exposure to Preeclampsia and Later Risk of Cardiometabolic Disorders: A Population-Based Cohort Study
Fetal preeclampsia exposure has been associated with later cardiometabolic disease. However, this association has been investigated in few large population-wide studies, and it is unknown whether the association represents a causal relationship or is the result of shared etiological factors.
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National health registers
Using data from The Medical Birth Registry of Norway and The Norwegian Prescription Database, we have looked at the risk of developing high blood pressure, diabetes and high cholesterol in young adulthood in individuals who were exposed to preeclampsia during fetal life. The individuals were followed until 2016 with regard to medical treatment for high blood pressure, diabetes and high cholesterol, registered in The Norwegian Prescription Database. In order to distinguish between underlying, familial factors (for example genetic factors) and preeclampsia itself as the direct cause of an increased risk of cardiovascular disease, we also studied the risk in sibling groups where some of the siblings were exposed to preeclampsia and others not and compared this both with sibling groups where no one was exposed and within the exposed sibling groups.
Generally increased risk of cardiovascular disease among individuals exposed to preeclampsia in the fetus
Compared to individuals in the general population who had not been exposed to preeclampsia in fetal life, individuals exposed to preeclampsia had an increased risk of high blood pressure, diabetes, and high cholesterol later in life. The risk of high blood pressure was increased by approx. 50% and for diabetes and high cholesterol with approx. 30%.
Approximately equal risk when comparing siblings where only one was exposed to preeclampsia
When we looked at the risk of cardiovascular disease in sibling groups where one sibling was exposed to preeclampsia in fetal life and the other was not, we found that the risk was increased for both the exposed and the non-exposed individual compared to individuals from sibling groups where no one was exposed . In addition, when we compared within sibling groups where some siblings were exposed and others were not, we found no increased risk of either high blood pressure, diabetes or high cholesterol among those who had been exposed to preeclampsia compared to their non-exposed siblings.
Main message
Our conclusion is that individuals exposed to preeclampsia in fetal life have an increased risk of developing high blood pressure, diabetes and high cholesterol later in life. However, this is probably due to underlying, common causal factors both for preeclampsia and for these conditions rather than the exposure to preeclampsia itself.
The results of this study have been published in the journal Hypertension.
Paramsothy A, Hegvik TA, Engeland A, Bjørge T, Egeland GM, Klungsøyr K. Fetal Exposure to Preeclampsia and Later Risk of Cardiometabolic Disorders: A Population-Based Cohort Study. Hypertension. 2023 Sep 22. doi: 10.1161/HYPERTENSIONAHA.122.20682. Epub ahead of print. PMID: 37737002.
