JAMA. 2015;314(15):1588-1598. doi:10.1001/jama.2015.12505.
Natalie Auger, MD, MSc, FRCPC1,2,3; William D. Fraser, MD, MSc, FRCSC3,4; Jessica Healy-Profitós, MPH1,3; Laura Arbour, MD, MSc, FRCPC, FCCMG5
[+] Author Affiliations
1Institut national de santé publique du Québec, Montreal, Quebec, Canada
2Department of Social and Preventive Medicine, University of Montreal, Montreal, Quebec, Canada
3University of Montreal Hospital Research Centre, Montreal, Quebec, Canada
4Department of Obstetrics and Gynecology, University of Sherbrooke, Sherbrooke, Quebec, Canada
5Department of Medical Genetics, University of British Columbia, Vancouver, British Columbia, Canada
Importance The risk of congenital heart defects in infants of women who had preeclampsia during pregnancy is poorly understood, despite shared angiogenic pathways in both conditions.
Objective To determine the prevalence of congenital heart defects in offspring of women with preeclampsia.
Design, Setting, and Participants Population-level analysis of live births before discharge, 1989-2012, was conducted for the entire province of Quebec, comprising a quarter of Canada’s population. All women who delivered an infant with or without heart defects in any Quebec hospital were included (N = 1 942 072 neonates).
Exposures Preeclampsia or eclampsia with onset before or after 34 weeks of gestation.
Main Outcomes and Measures Presence of any critical or noncritical congenital heart defect detected in infants at birth, comparing prevalence in those exposed and not exposed to preeclampsia.
Results The absolute prevalence of congenital heart defects was higher for infants of women with preeclampsia (16.7 per 1000 [1219/72 782]) than without it (8.6 per 1000 [16 077/1 869 290]; prevalence ratio [PR], 1.57; 95% CI, 1.48 to 1.67). Infants of preeclamptic women had no increased prevalence of critical heart defects (123.7 vs 75.6 per 100 000 [90/72 782 vs 1414/1 869 290]; PR, 1.25; 95% CI, 1.00 to 1.57; prevalence difference [PD], 23.6 per 100 000; 95% CI, −1.0 to 48.2) but did have an increased prevalence of noncritical heart defects (1538.8 vs 789.2 per 100 000 [1120/72 782 vs 14 752/1 869 290]; PR, 1.56; 95% CI, 1.47 to 1.67; PD, 521.1 per 100 000; 95% CI, 431.1 to 611.0) compared with infants of nonpreeclamptic women. Among specific defects, prevalence was greatest for septal defects. When stratified by variant of preeclampsia, infants of women with early onset (<34 weeks) preeclampsia had greater prevalence of critical heart defects (364.4 per 100 000 [20/5488]; PR, 2.78; 95% CI, 1.71-4.50; PD, 249.6 per 100 000; 95% CI, 89.7-409.6) and noncritical heart defects (7306.9 per 100 000 [401/5488]; PR, 5.55; 95% CI, 4.98-6.19; PD, 6089.2 per 100 000; 95% CI, 5350.0-6828.3), whereas infants of women with late onset (≥34 weeks) did not.
Conclusions and Relevance In this population-based study, preeclampsia was significantly associated with noncritical heart defects in offspring, and preeclampsia before 34 weeks was associated with critical heart defects. However, the absolute risk of congenital heart defects was low.
Pages listed in BOTH the categories Pregnancy and Hypertension (preeclampsia)
- Preeclampsia (low vitamin D) doubles the risk of later cardiovascular problems – Sept 2019
- Preeclampsia 11X more likely if poor Vitamin D Binding Protein (South Africa) - Sept 2019
- Preeclampsia 2X more likely if poor Vitamin D Receptor – April 2019
- Preeclampsia reduced 1.7 X by aspirin (but reduced 7 X by Vitamin D) – Feb 2018
- Preeclampsia risk reduced 7X by 4,000 IU of Vitamin D daily – RCT March 2018
- Preeclampsia of offspring cut in half if mother who smoked had vitamin D fortified margarine – Dec 2017
- Preeclampsia reduced 2X by Vitamin D, by 5X if also add Calcium – meta-analysis Oct 2017
- Child 49 percent higher risk of being overweight if hypertension during pregnancy – Sept 2017
- Preeclampsia risk reduced 60 percent if supplement with Vitamin D (they ignored dose size) – meta-analysis Sept 2017
- Preeclampsia recurrence reduced 2 X by 50,000 IU of vitamin D every two weeks – RCT July 2017
- Preeclampsia is not reduced by vitamin D (if you ignore vitamin D level, dose size, frequency and duration) – July 2017
- Preeclampsia doubles the risk of mild cognitive impairment – July 2017
- No Hypertension during pregnancy if more than 60 ng of vitamin D – RCT
- Preeclampsia changes to Vitamin D Binding Protein reduces Vitamin D in placenta – Dec 2016
- Preeclampsia risk reduced by higher levels of vitamin D (VDAART 4,400 IU) - RCT Nov 2016
- MAGNESIUM IN MAN - IMPLICATIONS FOR HEALTH AND DISEASE – review 2015
- Preeclampsia 4X less likely if vitamin D levels increased by 8 ng during pregnancy – March 2016
- Pre-eclampsia 2X more likely if low vitamin D, unless adjust for vitamin D factors (BMI, skin color) – Dec 2015
- Preeclampsia and eclampsia associated with lower vitamin D, etc. – Sept 2015
- Preeclampsia increased risk of Congenital Heart Defects by 60 percent (vitamin D not mentioned) Oct 2015
- Preeclampsia reduced by Vitamin D (50,000 IU bi-weekly) and Calcium – Oct 2015
- Burkas reduce vitamin D levels, which causes pregnancy problems – Oct 2015
- Preeclampsia – hypothesis as to why vitamin D helps – June 2015
- Preeclampsia inversely proportional to serum Magnesium – Oct 2014
- Hypertension in pregnancy (preeclampsia) more frequent in winter (low vitamin D) – Jan 2015
- Preeclampsia rate cut in half by high level of vitamin D – meta-analysis March 2014
- Preeclampsia 40 percent less likely if mother had more than 20 ng of vitamin D – Jan 2014
- Preeclampsia 2.7X more frequent if low vitamin D – meta-analysis Sept 2013
- During pregnancy even 400 IU helps metabolic status – RCT July 2013
- 2X more preeclampsia when vitamin D less than 30 ng, etc. - meta-analysis March 2013
- 7X increase in early severe preeclampsia associated with low vitamin D – Aug 2012
- Preeclampsia 3X more likely if low vitamin D at 25th week – April 2012
- Low vitamin D results in severe preeclampsia and low birth weight – Mar 2011
- Women with low vitamin D 4X more likely to have preeclampsia in pregnancy – Nov 2010
- Seasonal variation in pregnancy hypertension is correlated with sunlight intensity -June 2010 no abstract