Long‐term effects of preeclampsia on metabolic and biochemical outcomes in offspring: What can be expected from a meta‐analysis?

The objective of this study is to evaluate the long‐term effects of preeclampsia (PE) on metabolic and biochemical outcomes in offspring. We searched PubMed‐Medline, Web of Science, and EMBASE from inception to June 2021 for randomized clinical trials, cohort, and case–control studies. Two researchers independently extracted data according to the Preferred Reporting Items for Systematic Reviews and Meta‐analyses (PRISMA) guidelines and assessed possible bias. Rate ratios (RRs) or weighted mean differences (WMDs) were estimated using fixed‐effects model or random‐effects model if the heterogeneity was high. PE increased offspring risk of obesity (RR 1.45, 95% confident interval [CI] 1.19–1.78) with a mean weighted age of 9.1 years, and a higher body mass index from 10 years of age (WMD 0.46, 95% CI 0.08–0.83). PE offspring were associated with a higher mean arterial pressure (WMD 1.33, 95% CI 0.42–2.24), systolic blood pressure (WMD 1.93, 95% CI 1.48–2.37), and diastolic blood pressure (WMD 1.13, 95% CI 0.80–1.47) in puberty. However, we uncovered no association between PE and offspring levels of total cholesterol, triglycerides, high‐density lipoprotein, low‐density lipoprotein, glucose, and insulin in blood with puberty, nor was there an increase in the risk of type 1 diabetes mellitus in PE offspring under 15 years of age (RR 1.07, 95% CI 0.88–1.32). However, PE might be associated with central obesity, hypertension, and type 2 diabetes mellitus of offspring in later life. Offspring of mothers with PE exhibited an increased risk of obesity in childhood and a higher body mass index and blood pressure in puberty, but there were no differences in blood lipids or glucose metabolism in puberty compared to non‐PE offspring. PE might be associated with a higher risk for central obesity, hypertension, and type 2 diabetes mellitus of offspring in later life.