Preeclampsia: Risk Factors, Diagnosis, Management, and the Cardiovascular Impact on the Offspring
- PMID: 31590294
- PMCID: PMC6832549
- DOI: 10.3390/jcm8101625
Preeclampsia: Risk Factors, Diagnosis, Management, and the Cardiovascular Impact on the Offspring
Abstract
Hypertensive disorders of pregnancy affect up to 10% of pregnancies worldwide, which includes the 3%-5% of all pregnancies complicated by preeclampsia. Preeclampsia is defined as new onset hypertension after 20 weeks' gestation with evidence of maternal organ or uteroplacental dysfunction or proteinuria. Despite its prevalence, the risk factors that have been identified lack accuracy in predicting its onset and preventative therapies only moderately reduce a woman's risk of preeclampsia. Preeclampsia is a major cause of maternal morbidity and is associated with adverse foetal outcomes including intra-uterine growth restriction, preterm birth, placental abruption, foetal distress, and foetal death in utero. At present, national guidelines for foetal surveillance in preeclamptic pregnancies are inconsistent, due to a lack of evidence detailing the most appropriate assessment modalities as well as the timing and frequency at which assessments should be conducted. Current management of the foetus in preeclampsia involves timely delivery and prevention of adverse effects of prematurity with antenatal corticosteroids and/or magnesium sulphate depending on gestation. Alongside the risks to the foetus during pregnancy, there is also growing evidence that preeclampsia has long-term adverse effects on the offspring. In particular, preeclampsia has been associated with cardiovascular sequelae in the offspring including hypertension and altered vascular function.
Keywords: developmental origins of disease; foetal diseases; foetus; non-communicable disease; preeclampsia; pregnancy; prevention; treatment.
Conflict of interest statement
The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results.
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References
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- National Guideline Alliance (UK) Hypertension in Pregnancy: Diagnosis and Management (NG133) [(accessed on 3 October 2019)];2019 Available online: https://www.nice.org.uk/guidance/ng133.
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