Faculty of Health Sciences, Joyce & Irving Goldman Medical School at Ben-Gurion University of the Negev, Israel.
Department of Obstetrics and Gynecology, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
Pregnancy Hypertens. 2020 Jul;21:30-34. doi: 10.1016/j.preghy.2020.04.010. Epub 2020 Apr 28.
We evaluated the association between maternal preeclampsia and long-term infectious morbidity of the offspring.
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).
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).
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.
评估母亲子痫前期与子代长期传染性发病率之间的关联。
对 1991 年至 2014 年期间患有和未患有子痫前期的女性所生子女的长期传染性发病率风险进行回顾性队列分析。传染性发病率包括儿童期子女住院治疗的情况。婴儿随访至 18 岁或直至住院。排除多胎妊娠、新生儿先天性畸形和围产儿死亡。比较传染性发病率的累积发生率。采用 Cox 比例风险模型控制各种混杂因素，包括胎龄和剖宫产术（CD）。
在研究期间，共纳入 239725 名新生儿：96%（n=230217）无子痫前期，3%（n=7280）有轻度子痫前期，0.9%（n=2228）有重度子痫前期，主要依据是母体器官功能障碍的证据。与无子痫前期的母亲相比，患有重度子痫前期的母亲的子女因传染性疾病而住院的比例明显更高（13.1%比 11%，P=0.008），特别是呼吸道和细菌感染。Kaplan-Meier 生存曲线表明，重度子痫前期产妇所生子女的住院累积发病率显著更高（Log-rank 检验 P 值=0.026）。然而，在校正 Cox 回归模型中的混杂因素后，重度子痫前期并非独立的危险因素（调整后的危险比 0.95，95%置信区间 0.8-1.1，P=0.36）。
虽然重度子痫前期与子代长期传染性发病率风险增加有关，但这种关联似乎是由于早产和 CD 引起的，而不是子痫前期本身。
