Marciano Dor, Sheiner Eyal, Sergienko Ruslan, Wainstock Tamar
Department of Obstetrics and Gynecology, Soroka University Medical Center, Beer-Sheva, Israel.
Department of Public Health, Faculty of Health Science, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
Am J Reprod Immunol. 2025 Jan;93(1):e70041. doi: 10.1111/aji.70041.
Preeclampsia is a severe, multisystem complication that affects 2%-5% of pregnancies, and is a leading cause of fetal and maternal morbidity and mortality worldwide. Preeclampsia may have devastating results on maternal health and may affect offspring's immediate and long-term health. Previous studies have examined the impact of maternal preeclampsia on the long-term health outcomes of offspring, many of these studies have been limited by confounding factors that could bias the results. The classic way of analyzing the relationship between maternal preeclampsia and long-term infectious morbidity of the offspring, which typically involves comparing the rates of infectious disease hospitalization between the exposed and unexposed groups, may not be sufficient due to the potential influence of unmeasured confounding factors.
To study the association between maternal preeclampsia and long-term offspring infectious morbidity, while employing sibling-matched analysis to maximize confounder control.
A retrospective cohort was conducted, including parous women, who were diagnosed with preeclampsia in one pregnancy. A sibling-matched analysis was performed, so that one sibling was, and the other was not, prenatally exposed to maternal preeclampsia. Incidence of the offspring hospitalization with infectious morbidities were compared between the siblings, as well as the time to first hospitalization with such a diagnosis. Multivariable survival analysis was performed to adjust for confounding variables.
Offspring of mothers with preeclampsia (n = 4272) were significantly (p < 0.001) at a higher risk for long-term infectious hospitalization compared to offspring of mothers without preeclampsia (n = 4272), with a hazard ratio of 1.324 (95% CI 1.168-1.503) after adjusting for maternal age, gestational age, and mode of delivery.
Offspring born following pregnancies complicated with preeclampsia are at increased risk for infectious morbidity, even while rigorously adjusting for confounders in a sibling analysis.
子痫前期是一种严重的多系统并发症，影响2%-5%的妊娠，是全球范围内胎儿和孕产妇发病及死亡的主要原因。子痫前期可能对孕产妇健康产生毁灭性后果，并可能影响后代的近期和长期健康。先前的研究已探讨孕产妇子痫前期对后代长期健康结局的影响，但其中许多研究受到可能使结果产生偏差的混杂因素的限制。分析孕产妇子痫前期与后代长期感染性发病之间关系的经典方法，通常是比较暴露组和非暴露组之间的传染病住院率，但由于未测量的混杂因素的潜在影响，这种方法可能并不充分。
研究孕产妇子痫前期与后代长期感染性发病之间的关联，同时采用同胞匹配分析以最大程度地控制混杂因素。
进行了一项回顾性队列研究，纳入在一次妊娠中被诊断为子痫前期的经产妇。进行了同胞匹配分析，使一个同胞在产前暴露于孕产妇子痫前期，而另一个未暴露。比较了同胞之间后代因感染性疾病住院的发生率以及首次因该诊断住院的时间。进行了多变量生存分析以调整混杂变量。
与未患子痫前期母亲的后代（n = 4272）相比，患子痫前期母亲的后代（n = 4272）长期感染性住院的风险显著更高（p < 0.001），在调整孕产妇年龄、孕周和分娩方式后，风险比为1.324（95%CI 1.168-1.503）。
即使在同胞分析中严格调整混杂因素，子痫前期妊娠后出生的后代感染性发病风险仍会增加。
