Table 2.
Studies assessing the impact of preeclampsia exposure on growth in infancy (birth – 2 years)
| First Author (Year) | Study Type | Exposure (Number) | Outcomes Assessed | Main Findings at 2 Yearsa (PE versus NTP-exposed infants) | Adjusted Confounders | Comments |
|---|---|---|---|---|---|---|
| Szymonowicz (1987) [23] | Prospective case–control | PE (35) NTP (35) | Weight | PE lower | Nil |
Cohort: preterm, VLBW infantsb ROB: Low |
| Length | ND | |||||
| Head circumference | ||||||
|
Martikainen (1989) [24] |
Prospective cohort |
PE (31 preterm, 40 term) NTP (128 preterm, 175 term) |
Weight Length |
Preterm: PE lower Term: ND |
Infant sex, GA |
Also assessed other HDPs Cohort stratified by hypertension exposure, prematurity and SGA status. Assessed 18-month outcomes ROB: Low |
|
Weight gain Length gain |
Term PE: greater catch up than preterm PE infants | |||||
| Head circumference |
Preterm: ND Term: PE higher |
|||||
| Cheng (2004) [25] | Retrospective cohort |
PE (28) NTP (61) |
Weight | ND | Nil |
Cohort: very preterm (< 32 weeks), VLBW infantsb. Small sample size ROB: Low |
| Length | ||||||
| Head circumference | ||||||
| Silveira (2007) [26] | Prospective cohort |
PE (40) NTP (46) |
Weight, Weight-for-age |
PE lower, slower catch-up weight in VLBW PE than VLBW NTP | GA |
Cohort: preterm, VLBW infantsb. Assessed 12, 18-month outcomes ROB: Low |
| Length-for-age | ND | |||||
| Head circumference | PE lower | |||||
| Weight-for-length | ||||||
| Davis (2015) [18] | Prospective cohort |
C-HTNc (89) NTP (1434) |
Weight | ND | Infant sex, GA, birthweight |
Grouped PE and GH causing preterm birth into C-HTN Assessed 12-month outcomes. Assessed growth and CVD risk to 20 years ROB: Low |
| Length | ||||||
| BMI | ||||||
| Byberg (2017) [27] | Nested case–control |
S-PEc (54) M/M-PEc (164) NTP (385) |
Weight z-score | PE lower (all) |
Infant sex, age Maternal age, BMI, antenatal smoking, education |
Considered severity of PE Assessed growth to 13 years No adjustment for GA or birthweight ROB: Low |
| Length z-score gain | M/M-PE boys greater, S-PE boys and all girls lower | |||||
| BMI | MM-PE girls greater, S-PE girls and all boys lower | |||||
| Matić (2017) [28] | Retrospective cohort |
GH/PE (261) NTP (1212) |
Weight | GH/PE lower | Nil |
Grouped PE and GH Cohort: 2–3 year old infants born very preterm (< 29 weeks)b. Powered for chronic lung disease and neurodevelopment ROB: Low |
| Length | ||||||
| Head circumference | ||||||
| Gunnarsdottir (2018) [29] | Retrospective cohort |
S-PEc + M/M-PEc (865) NTP (22,898) |
Length z-score | S-PE lower |
Infant sex, GA, birthweight, SGA status, breastfeeding status Maternal age, parity, height, BMI, diabetes, smoking, education, country of birth Paternal smoking |
Assessed 18-month outcomes. Assessed growth from birth to 5 years. No adjustment for paternal factors influencing length ROB: Low |
| Length gain | All PE greater, especially S-PE than M/M-PE infants, partly associated with GA | |||||
| Huang (2020) [30] | Prospective cohort |
PE (24) NTP (168) |
BMI | PE greater |
Infant sex, GA, birthweight Maternal age, parity, gestational diabetes mellitus, education, marital status |
Considered association of both gestational diabetes mellitus and PE on growth. Assessed 18, 24-month outcomes. Assessed growth to 6 years. Small sample size ROB: Low |
| Gow (2021) [31] | Prospective cohort |
PE (84) NTP (298) |
Weight Weight z-score |
PE lower |
Infant sex, GA, NICU/SCN stay length, feeding status, labour onset, mode of delivery Maternal age, weight, BMI, parity, ethnicity, smoking, education |
Assessed 6-month outcomes ROB: Low |
| Weight gain | PE greater | |||||
|
Weight z-score gain Rapid weight gain Conditional weight gain |
ND, any SGA greater than not SGA | |||||
|
Length Length z-score |
PE lower ND |
|||||
|
Length gain Length z-score gain |
PE greater ND |
|||||
| BMI | ND | |||||
| Jasper (2021) [32] | Retrospective cohort |
PE (659) NTP (1909) |
Rate of weight z-score gain | ND |
Infant birthweight, GA, head circumference, multiple birth, postnatal hospitalisation, year of birth, mode of delivery, perinatal complications Maternal age, BMI, ethnicity, SES |
Cohort: preterm infantsb Many perinatal exposures assessed, including PE ROB: Low |
Abbreviations: BMI Body mass index, C-HTNc Complicated hypertension exposed, CVD Cardiovascular disease, FGR Fetal growth restriction, GA Gestational age at birth, GH Gestational hypertension, M/M-PEc Mild/moderate preeclampsia, ND No difference, NICU/SCN Neonatal intensive care unit/special care nursery, NTP Normotensive pregnancy, PE Preeclampsia, ROB Risk of bias, SGA Small for gestational age, S-PEc Severe preeclampsia, VLBW Very low birth weight
aAll results in the ‘Main Findings’ column are of infant growth outcomes at 2 years, unless specified in the ‘Comments’ column. Any study that continued reporting outcomes beyond 2 years is also specified
bPreterm birth was defined as birth < 37 weeks’ gestation. VLBW was defined as birthweight < 1500 g. SGA birth was defined as birthweight corrected for gestational age < 10th centile. Study-specific definitions of ‘very preterm’ are specified in the ‘Comments’ column
cMild/moderate PE and severe PE definitions differed between studies: Davis et al. (2015) [18] combined PE and gestational hypertension severe enough to result in preterm delivery into C-HTN; Byberg et al. (2017) [27] used criteria developed by the CLASP study based on blood pressure and proteinuria levels at GA 20 weeks [33, 34]; Gunnarsdottir et al. (2018) [29] used the WHO ICD-10 classifications [35]