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Hypertensive disorders during pregnancy and health outcomes in the offspring: a systematic review

Published online by Cambridge University Press:  11 May 2016

T. V. Pinheiro*
Saúde da Criança e do Adolescente, Universidade Federal do Rio Grande do Sul, Brazil
S. Brunetto
Saúde da Criança e do Adolescente, Universidade Federal do Rio Grande do Sul, Brazil
J. G. L. Ramos
Department of Gynecology and Obstetrics, Universidade Federal do Rio Grande do Sul, Brazil
J. R. Bernardi
Saúde da Criança e do Adolescente, Universidade Federal do Rio Grande do Sul, Brazil
M. Z. Goldani
Saúde da Criança e do Adolescente, Universidade Federal do Rio Grande do Sul, Brazil Department of Pediatrics, Universidade Federal do Rio Grande do Sul, Brazil
*Address for correspondence: T. V. Pinheiro, Department of Paediatrics, Universidade Federal do Rio Grande do Sul, R. Ramiro Barcelos, 2350 – Santa Cecilia, Porto Alegre, Rio Grande do Sul 90035-903, Brazil. (Email


The hypertensive disorders of pregnancy complicate up to 10% of pregnancies worldwide and are a leading cause of maternal, foetal, and neonatal morbidity and mortality. The aim of this study was to present an overview of recent studies addressing offspring’s medium and long-term health outcomes after intrauterine exposure to maternal hypertension. A search on PubMed/MEDLINE and Bireme databases was conducted to identify observational studies that reported any offspring outcome measured after the 6th month of life. The search was limited to studies published after May 2008. Forty-five articles were included and categorized into four groups of outcomes: cardiovascular, immune, metabolic and behavioural/neurological effects. According to our findings, hypertensive disorders of pregnancy had an overall negative impact on offspring’s cardiovascular, immune and neurological health, although not all parameters analysed in each group had consistent results among studies. The most prominent and reliable associations were verified between gestational hypertension and higher offspring’s blood pressure and between preeclampsia and offspring’s lower cognitive functioning. In the metabolic outcomes, body composition had conflicting results among papers, while all studies that examined blood biomarkers showed no evidence that preeclampsia or gestational hypertension could be associated with an alteration of this metabolic outcomes. Most included studies were highly heterogeneous regarding the measure of outcomes and covariables used for adjustments. Future studies should consider using the same protocols and cut-off points already published so that results can be better compared and summarized.

This review was registered in PROSPERO. Registration number: CRD42015020838

© Cambridge University Press and the International Society for Developmental Origins of Health and Disease 2016 

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