Preeclampsia and Its Consequences for Fetal Development and Newborn Health
Preeclampsia and Its Consequences for Fetal Development and Newborn Health
Samaneh Safaei,1,*
1. Bachelor student of Midwifery, Azad University of Tonekabon
Introduction: Preeclampsia is a convoluted hypertensive disorder of pregnancy that typically occurs after 20 weeks of gestation. Affecting 2-8% of pregnancies globally, it is a major cause of maternal and fetal morbidity and mortality. The condition is defined by new-onset hypertension and proteinuria, or in some cases, other organ dysfunctions. Preeclampsia interferes placental function, leading to imperiled fetal growth and proliferated risk of preterm birth, intrauterine growth restriction (IUGR), low birth weight (LBW), and even perinatal death. Although maternal consequences are often prioritized in clinical care, the outcomes for the fetus are equally severe, with long-term developmental implications. This review aims to synthesize the current understanding of preeclampsia’s impact on fetal sequels, exploring both short-term neonatal complications and potential long-term developmental challenges.
Methods: A systematic review was conducted using PubMed, Cochrane, and Scopus databases. Studies published between 2010 and 2023 that examined the relevance between preeclampsia and fetal outcomes were included. The search strategy focused on key terms such as “preeclampsia,” “fetal outcomes,” “preterm birth,” “intrauterine growth restriction,” and “neurodevelopmental delay.” Both observational and interventional studies, including cohort studies, randomized controlled trials, and meta-analyses, were considered for inclusion. Studies involving human subjects and published in English were taken precedence. Amongst of 200 articles, 45 studies were deemed relevant based on predefined criteria, including a clear focus on fetal outcomes in pregnancies complicated by preeclampsia.
Results: The review distinguished several key fetal outcomes strongly associated with preeclampsia. Preterm birth was amongst the most common complications, with rates ranging from 30-50% in affected pregnancies. Preterm birth, often medically revealed to prevent maternal and fetal complications, significantly contributes to neonatal morbidity, including respiratory distress syndrome (RDS), infections, and long-term developmental delays. Intrauterine growth restriction (IUGR) was reported in approximately 25-40% of pregnancies complicated by preeclampsia, primarily due to impaired placental blood flow. This restricted nutrient and oxygen transfer to the fetus results in small-for-gestational-age (SGA) infants and is a key predictor of adverse neonatal outcomes.
Low birth weight (LBW), closely related to IUGR, was another prominent finding, with infants exposed to preeclampsia being twice as likely to be born with LBW compared to those from normotensive pregnancies. These infants are often admitted to neonatal intensive care units (NICUs) for closer monitoring and treatment of complications such as hypoglycemia, temperature, and feeding difficulties.
Perinatal mortality rates were found to be elevated in pregnancies affected by preeclampsia, with a 2-4 times higher risk of stillbirth and neonatal death. These outcomes were particularly common in early-onset preeclampsia (before 34 weeks), where both the severity of the condition and the immaturity of the fetus contribute to adverse outcomes.
Long-term follow-up studies indicated that infants born to mothers with preeclampsia may confront neurodevelopmental challenges, including delays in motor function and cognitive skills. There is growing evidence suggesting that these children may be at higher risk for conditions such as cerebral palsy and attention deficit hyperactivity disorder (ADHD), although the exact mechanisms linking preeclampsia to these outcomes require further investigation.
Conclusion: Preeclampsia poses significant risks to fetal health, fundamentally through mechanisms of placental insufficiency that result in IUGR, preterm birth, and low birth weight. Despite advances in obstetric care, preeclampsia persists a leading cause of adverse fetal outcomes, particularly in low-resource settings where access to timely medical interventions is limited. Future research would concentrate on early detection and management strategies that minimize fetal risks, as well as long-term follow-up of children born to preeclamptic mothers to evaluate and control developmental challenges.