Pre-eclampsia is associated with increased risk of stroke in the adult offspring the helsinki birth cohort study

Eero Kajantie, Johan G. Eriksson, Clive Osmond, Kent Thornburg, David J P Barker

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    273 Scopus citations

    Abstract

    Background and Purpose-Women who develop pre-eclampsia in pregnancy are at increased risk of cardiovascular disease. The offspring from pregnancies complicated by pre-eclampsia have higher blood pressures during childhood, but little is known about their long-term health. We hypothesized that pre-eclampsia would lead to an increased risk of cardiovascular disease in the offspring. Methods-We traced 6410 babies born in Helsinki, Finland, from 1934 to 1944. We used the mothers' blood pressure levels and the presence of proteinuria during pregnancy to define pre-eclampsia and gestational hypertension without proteinuria according to modern criteria. Results-Two hundred eighty-four of the pregnancies were complicated by pre-eclampsia (120 with nonsevere and 164 with severe disease) and 1592 by gestational hypertension. The crude hazard ratio for all forms of stroke among people whose mothers had pre-eclampsia was 1.9 (1.2 to 3.0; P=0.01); among people whose mothers had gestational hypertension, it was 1.4 (1.0 to 1.8; P=0.03). There was no evidence that these pregnancy disorders were associated with coronary heart disease in the offspring. Pre-eclampsia, in particular severe disease, was associated with a reduced mean head circumference at birth, whereas gestational hypertension was associated with an increased head circumference in relation to body length. Conclusions-People born after pregnancies complicated by pre-eclampsia or gestational hypertension are at increased risk of stroke. The underlying processes may include a local disorder of the blood vessels of the brain as a consequence of either reduced brain growth or impaired brain growth leading to "brain-sparing" responses in utero.

    Original languageEnglish (US)
    Pages (from-to)1176-1180
    Number of pages5
    JournalStroke
    Volume40
    Issue number4
    DOIs
    Publication statusPublished - Apr 1 2009

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    Keywords

    • Coronary artery disease
    • Pre-eclampsia
    • Pregnancy
    • Pregnancy complications
    • Stroke

    ASJC Scopus subject areas

    • Cardiology and Cardiovascular Medicine
    • Clinical Neurology
    • Advanced and Specialized Nursing
    • Medicine(all)

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