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TOPLINE:

Children exposed to maternal preeclampsia and born at term (37 weeks or more) were 26% more likely to develop kidney disease in the first year of life than those not exposed. They also faced notably high risks for chronic, unspecified, and diabetic kidney diseases as they grew older, particularly at or after 25 years of age.

METHODOLOGY:

• Researchers conducted a nationwide register-based cohort study to examine the association between maternal preeclampsia and the risk for kidney disease in their offspring.
• They analysed data of 2,288,589 offsprings born in Denmark between 1978 and 2017, of whom 63,191 (17.7% preterm) were exposed to maternal preeclampsia; mothers of the included offsprings were required to have pregnancy durations of more than 20 weeks.
• Information on maternal preeclampsia was identified from the National Patient Register; offsprings were categorised on the basis of their gestational age at birth as early preterm (< 34 weeks), late preterm (34-36 weeks), and term (≥ 37 weeks).
• Offsprings were considered to have kidney disease if they were registered with any of the following diagnoses: Acute or chronic kidney disease, glomerular and proteinuric disease, diabetic kidney disease, unspecified kidney disease, or kidney disease due to external causes.
• The median follow-up duration of this cohort was 18.8 years.

TAKEAWAY:

• During the follow-up period, 37,782 individuals developed kidney disease, including 1150 who were exposed to maternal preeclampsia.
• O ffsprings exposed to maternal preeclampsia had a higher risk of developing overall kidney disease within the first year of life, irrespective of gestational age at delivery (hazard ratio [HR], 1.41; 95% CI, 1.05-1.90 for preterm birth and HR, 1.26; 95% CI, 1.09-1.46 for term birth), than those not exposed to maternal preeclampsia and born at term.
• In offsprings born at term, exposure to maternal preeclampsia was strongly associated with increased risks for chronic kidney disease, unspecified kidney disease, and diabetic kidney disease (HR range, 1.36-2.85) at or after the age of 25 years.
• Exposure to preeclampsia with preterm delivery was not linked to higher rates of kidney disease in offsprings beyond the first year of life.

IN PRACTICE:

"In adolescents and young adults presenting with signs and symptoms of kidney dysfunction, a history of maternal preeclampsia may warrant an upweighting of kidney disease in the differential diagnosis, despite the patient's youth," the authors wrote.

SOURCE:

This study was led by Ida Lihme, Statens Serum Institut, Copenhagen, Denmark. It was published online on May 16, 2025, in Kidney International.

LIMITATIONS:

Relatively few individuals were exposed to preterm preeclampsia and developed kidney disease, which may have yielded unstable results in some subanalyses and made it difficult to assess associations with early and late preterm preeclampsia separately. In analyses of individual kidney disease subtypes, evidence for associations with preterm preeclampsia was often lacking, likely due to a lack of statistical power.

DISCLOSURES:

Two authors reported receiving grants from various sources, including the US National Institutes of Health, Danish Council for Independent Research, and Novo Nordisk Foundation.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.