(491) Association Between Preeclampsia and Offspring Congenital Heart Disease

Prior literature has described an association between preeclampsia and congenital heart disease (CHD), while also suggesting that there may be a stronger relationship in individuals with early preeclampsia. We sought to explore that relationship within the same pregnancy in a large population-based study.

Study Design:

We conducted a retrospective cohort study utilizing linked vital statistics-patient discharge data in California (2000-2012). We included singleton births with gestational age of 23-42 weeks and excluded pregnancies complicated by pre-existing diabetes or major identified chromosomal anomalies. We compared the prevalence of offspring with CHD (excluding patent ductus arteriosus and patent foramen ovale) in pregnancies with and without preeclampsia. Multivariable logistic regression was used to examine association of preeclampsia with fetal CHD. We further looked at the association of preterm delivery ( < 34 weeks) with offspring’s CHD among preeclamptic patients.

Results:

Among 5,843,440 pregnant patients, 3.61% had preeclampsia., There was a significantly higher prevalence of offspring CHD among preeclamptic patients compared to pregnancies without preeclampsia (1.16% vs 0.54%, p< 0.001). Multivariable logistic regression analyses showed that preeclamptic patients had increased risk of having a baby with CHD (aOR 2.06, 95% CI 1.97-2.14). Among those with preeclampsia, odds of having a baby with CHD were higher among pregnant patients who delivered < 34 weeks (aOR = 4.14, 95% CI 3.81-4.51).

Conclusion:

There is an increased risk of CHD in pregnancies complicated by preeclampsia. Furthermore, this risk is doubled in preeclamptic patients who delivered before 34 weeks, consistent with potentially different mechanistic effects of early versus late preeclampsia on both the pregnant patient and child.