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Blood Pressure, Serum Lipids, Fasting Insulin, and Adrenal Hormones in 12-Year-Old Children Born with Maternal Preeclampsia

Department of Pediatrics, Kuopio University Hospital (S.T., E.R., A.M., R.V.), and Computing Center, Kuopio University (P.H.), FIN-70211 Kuopio, Finland

Address all correspondence and requests for reprints to: Dr. Raimo Voutilainen, Department of Pediatrics, Kuopio University Hospital, P.O. Box 1777, FIN-70211 Kuopio, Finland. E-mail address: raimo.voutilainen{at}uku.fi.

Women with prior preeclamptic pregnancies have an increased risk for metabolic syndrome and cardiovascular diseases. Maternal preeclampsia has been associated with elevated blood pressure (BP) in offspring during childhood. The aim of our study was to determine whether elevated BP pressure and metabolic changes, such as dyslipidemia, insulin resistance, and increased adrenal hormonal activity, are found in 12-yr-old children of preeclamptic mothers. Sixty children born after preeclamptic pregnancy (PRE) and 60 matched control subjects born after normotensive pregnancy (non-PRE) were studied at the age of 12 yr. The case-control pairs were matched for sex, gestational age (±1 wk), and size at birth. We measured BP and concentrations of blood glucose, serum fasting insulin, total and high density lipoprotein cholesterol, triglycerides, cortisol, dehydroepiandrosterone sulfate, and plasma epinephrine (E) and norepinephrine (NE). Low density lipoprotein cholesterol was calculated according to the Friedewald-Fredrickson formula.

The PRE children had significantly higher mean systolic (116.4 vs. 113.2 mm Hg; P = 0.021) and diastolic (73.9 vs. 70.3 mm Hg; P = 0.022) BP than the non-PRE children, even when adjusted by current weight and height. At 12 yr of age, systolic BP values correlated inversely with birth weight (r = -0.459; P < 0.001) and length SD scores (r = -0.429; P = 0.001) in the PRE children. The mean concentrations of serum total, low density lipoprotein, and high density lipoprotein cholesterol; triglycerides; fasting insulin; blood glucose; serum cortisol; and dehydroepiandrosterone sulfate did not differ between the PRE and non-PRE groups. However, the mean plasma E concentration was higher in the PRE than in the non-PRE children (0.32 vs. 0.28 nmol/liter; P = 0.042), whereas the mean NE concentration did not differ between these two groups. In conclusion, 12-yr-old children born with maternal preeclampsia had elevated systolic and diastolic BPs and slightly increased E levels in the circulation. It is not known whether these changes are caused by genetic factors or by preeclampsia itself.

This work was supported by Kuopio University Hospital, Academy of Finland, Sigrid Jusélius Foundation, Pediatric Research Foundation, and Emil Aaltonen Foundation.

Abbreviations: AGA, Appropriate for gestational age; BP, blood pressure; CV, coefficient(s) of variation; DHEAS, dehydroepiandrosterone sulfate; E, epinephrine; HDL, high density lipoprotein; 11ßHSD2, 11ß-hydroxysteroid dehydrogenase type 2; LDL, low density lipoprotein; NE, norepinephrine; non-PRE, normotensive pregnancy; PRE, preeclamptic pregnancy; PSEH, parent-specific expected height; SGA, small for gestational age.

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