School of Public Health, Zhejiang University Medical School, Hangzhou, China.
Department of Maternal and Child Health, School of Public Health, Peking University, National Health Commission Key Laboratory of Reproductive Health, Beijing, China.
Front Endocrinol (Lausanne). 2022 Aug 23;13:906781. doi: 10.3389/fendo.2022.906781. eCollection 2022.
The association of gestational hypertension (GH) and preeclampsia (PE) with offspring adiposity outcomes had controversial results in different studies.
We conducted a systematic review and meta-analysis to evaluate the relationship between maternal GH/PE and offspring adiposity outcomes.
Studies were identified in PubMed, Embase, and Cochrane databases, with keywords including "gestational hypertension", "preeclampsia", "offspring", "weight", "cohort study", etc., without year restriction. This study was registered with PROSPERO, CRD42022292084.
We set the selection criteria for six aspects: population, outcome, time frame, study design, and availability. For the studies included in the meta-analysis, we required the potential confounders in these studies have been adjusted.
Two reviewers independently evaluated the data from the included studies. The meta-analyses included mean differences, regression coefficients, and corresponding 95% confidence intervals. Results were performed using RevMan software (version 5.4; Cochrane Collaboration). Heterogeneity among the included studies was assessed using the I statistic.
A total of 16 studies were included in our review, 15 of which were evaluated as high quality. In all offspring, during the early life (28 days-36 months), GH/PE exposure was found to be not or inversely associated with offspring obesity, then become positively associated at larger ages (3-19 years old). In offspring with adverse birth outcomes, the maternal GH/PE-exposed group had a lower weight in the short term (28 days to 18 months), but there was a trend of rapid weight gain as they grew older, compared with the non-exposed group. The meta-analysis showed that the BMI of the female offspring in the maternal PE-exposed group was significantly higher than that of the non-exposed offspring (MD=1.04, 95% CI: 0.67~1.42, < 0.05).
The systematic review suggested that maternal exposure to hypertension disorders of pregnancy (HDP) was associated with obesity in offspring, extending from early childhood to adolescence. The meta-analysis showed that PE was associated with higher BMI in female offspring. More studies are needed to conduct stratified analyses by PE/GH, the severity of HDP, or gender.
PROSPERO, identifier CRD42022292084.
妊娠高血压（GH）和子痫前期（PE）与后代肥胖结局的关联在不同研究中存在争议结果。
我们进行了系统评价和荟萃分析，以评估母体 GH/PE 与后代肥胖结局的关系。
使用 PubMed、Embase 和 Cochrane 数据库中的关键词，包括“gestational hypertension”、“preeclampsia”、“offspring”、“weight”、“cohort study”等，无时间限制。本研究已在 PROSPERO 注册，CRD42022292084。
我们为六个方面设定了选择标准：人群、结局、时间框架、研究设计和可获得性。对于纳入荟萃分析的研究，我们要求这些研究中潜在的混杂因素已得到调整。
两位评审员独立评估了纳入研究的数据。荟萃分析包括平均值差异、回归系数和相应的 95%置信区间。使用 RevMan 软件（版本 5.4；Cochrane 协作）进行结果分析。使用 I 统计量评估纳入研究的异质性。
共有 16 项研究纳入我们的综述，其中 15 项被评为高质量。在所有后代中，在生命早期（28 天至 36 个月），GH/PE 暴露与后代肥胖无关或呈负相关，然后在较大年龄（3-19 岁）与后代肥胖呈正相关。在有不良出生结局的后代中，母体 GH/PE 暴露组在短期内（28 天至 18 个月）体重较低，但随着年龄的增长，体重增长趋势较快，与未暴露组相比。荟萃分析表明，母体 PE 暴露组女性后代的 BMI 显著高于未暴露组（MD=1.04，95%CI：0.67~1.42，<0.05）。
系统评价表明，母体妊娠高血压疾病（HDP）暴露与后代肥胖有关，从儿童早期延伸到青春期。荟萃分析表明，PE 与女性后代的 BMI 较高有关。需要更多的研究来按 PE/GH、HDP 的严重程度或性别进行分层分析。
PROSPERO，标识符 CRD42022292084。
