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Risk of severe pre-eclampsia higher in those born small for gestational age

Obstetrics and gynaecology

Obstetrics and gynaecology

It has been known for more than a decade that the conditions an individual is exposed to in utero, such as maternal pre-eclamptic toxaemia (PET) or being born small for gestational age (SGA), can have consequences on future risk of ill health. A study from Sweden has now provided further evidence of an increased risk of severe pre-eclampsia for those born SGA.

The study looked at a large cohort of women, for whom data was held on both their fetal life and their own first pregnancies. It aimed to determine whether being born SGA, or having been exposed to pre-eclampsia before birth, increased the risk of developing PET.

The study used the Swedish medical births register to identify 118,634 women whose birth data were held and who subsequently had a first singleton pregnancy. Of these, 6,883 had been born SGA. These women were compared with non-SGA women. The analysis controlled for smoking, BMI and maternal PET.

The study revealed that being born SGA does increase a child's future risk of developing severe, but not mild, PET.

The risk of severe PET was almost doubled by being born SGA (odds ratio 1.6 to 1.69 depending on method of regression analysis). Girls born to pre-eclamptic mothers grew up with an increased risk of both mild and severe PET (odds ratios 1.82 and 2.08 respectively).

The authors suggest that inquiring about a pregnant woman's birth history is useful.

Pregnant women who were born SGA or whose own mothers had PET are a group at increased risk of poor obstetric outcome and should be offered more intensive antenatal surveillance.

Zetterstrom K, Lindeberg S, Haglund B, et al. Being born small for gestational age increases the risk of severe pre-eclampsia BJOG 2007;144:319-24

Reviewer

Dr Chris Barclay
GP, Sheffield

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