To Örebro University

PURPOSE: To evaluate growth, blood pressure and ophthalmological status in preschool children born preterm to mothers with preeclampsia.

METHODS: In a prospective cohort study, 78 children (34 girls) born preterm without retinopathy of prematurity were examined regarding length/height, weight, head circumference and insulin-like growth factor I (IGF-I) at birth and at 5 years of age. At 5 years, IGF-binding protein 3 and blood pressure were also measured. A detailed ophthalmological examination including ocular dimensions, fundus morphology, visual fields, visual evoked potentials and perceptual visual dysfunction was performed. Children born to preeclamptic mothers (n = 24) were compared to children with non-preeclamptic mothers (n = 54).

RESULTS: Children exposed to preeclampsia had lower weight (p = 0.0002, mean difference -1.46, 95% CI -2.09; -0.83), length (p = 0.013, -1.10, 95% CI -1.92; -0.23) and IGF-I levels (p = 0.0002, -26.0, 95% CI -36.0; -16.1) at birth compared to non-exposed children. At 5 years of age, the preeclamptic group had larger optic cup areas (p = 0.0006, 0.32, 95% CI 0.15; 0.46, in right eye, p = 0.049, 0.18, 95% CI 0.001; 0.35, in left eye). There was no significant difference between the groups regarding other ophthalmological findings or blood pressure. Children with reduced eye motility had lower neonatal IGF-I levels (p = 0.033, 15.5, 95% CI 1.1; 30.3).

CONCLUSION: Preeclampsia was shown to affect growth and IGF-I levels, confirming previous studies. Children exposed to preeclampsia were shown to have larger optic cup areas. Furthermore, lower neonatal IGF-I levels were seen in preterm children with reduced eye motility at 5 years of age.