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中华产科急救电子杂志 ›› 2026, Vol. 15 ›› Issue (03) : 141 -145. doi: 10.3877/cma.j.issn.2095-3259.2026.03.003

子痫前期及其并发症

子痫前期对胎儿生长发育的近期及远期影响
林莉, 时春艳()   
  1. 100034 北京大学第一医院妇产生殖医学中心
  • 收稿日期:2026-05-15 出版日期:2026-08-18
  • 通信作者: 时春艳
  • 基金资助:
    国家自然科学基金项目(82301910)

Short-term and long-term effects of preeclampsia on fetal growth and development

Li Lin, Chunyan Shi()   

  • Received:2026-05-15 Published:2026-08-18
  • Corresponding author: Chunyan Shi
引用本文:

林莉, 时春艳. 子痫前期对胎儿生长发育的近期及远期影响[J/OL]. 中华产科急救电子杂志, 2026, 15(03): 141-145.

Li Lin, Chunyan Shi. Short-term and long-term effects of preeclampsia on fetal growth and development[J/OL]. Chinese Journal of Obstetric Emergency(Electronic Edition), 2026, 15(03): 141-145.

子痫前期是妊娠期特发的综合征,可通过胎盘灌注不良、血管生成失衡、炎症反应及氧化应激等机制影响胎儿宫内发育,其对子代健康的影响不仅限于围产期,还可延续至儿童期、青少年期甚至成年期。本文就子痫前期与胎儿生长受限、早产、围产期不良结局,子代远期心血管、代谢、神经发育、呼吸和肾脏等系统疾病风险升高之间的关系,以及高危人群管理和长期随访的意义进行讨论。

Preeclampsia is a pregnancy-specific syndrome that may affect intrauterine fetal development through mechanisms including inadequate placental perfusion, angiogenic imbalance, inflammation, and oxidative stress. Its effects on offspring health extends beyond the perinatal period and may persist into childhood, adolescence, and even adulthood. This review discusses the associations of preeclampsia with fetal growth restriction, preterm birth, adverse perinatal outcomes, and increased long-term risks of cardiovascular, metabolic, neurodevelopmental, respiratory, and renal diseases in offspring. The management of high-risk populations and the importance of long-term follow-up are also addressed.

[1]
Chappell LC, Cluver CA, Kingdom J, et al. Pre-eclampsia[J]. Lancet2021398(10297):341-354.
[2]
Rana S, Lemoine E, Granger JP, et al. Preeclampsia: pathophysiology, challenges, and perspectives[J]. Circ Res2019124(7):1094-1112.
[3]
Koulouraki S, Paschos V, Pervanidou P, et al. Short- and long-term outcomes of preeclampsia in offspring: review of the literature[J]. Children (Basel)202310(5):826.
[4]
Yang Y, Le Ray I, Zhu J, et al. Preeclampsia prevalence, risk factors, and pregnancy outcomes in Sweden and China[J]. JAMA Netw Open20214(5):e218401.
[5]
Korzeniewski SJ, Sutton E, Escudero C, et al. The Global Pregnancy Collaboration (CoLab) symposium on short- and long-term outcomes in offspring whose mothers had preeclampsia: a scoping review of clinical evidence[J]. Front Med (Lausanne)20229:984291.
[6]
Gluckman PD, Hanson MA, Cooper C, et al. Effect of in utero and early-life conditions on adult health and disease[J]. N Engl J Med2008359(1):61-73.
[7]
Hanson MA, Gluckman PD. Developmental origins of health and disease: new insights[J]. Basic Clin Pharmacol Toxicol2008102(2):90-93.
[8]
Burton GJ, Jauniaux E. Pathophysiology of placental-derived fetal growth restriction[J]. Am J Obstet Gynecol2018218(2S):S745-761.
[9]
中华医学会妇产科学分会妊娠期高血压疾病学组.妊娠期高血压疾病诊治指南(2020)[J].中华妇产科杂志202055(4):227-238.
[10]
Stepan H, Galindo A, Hund M, et al. Clinical utility of sFlt-1 and PlGF in screening, prediction, diagnosis and monitoring of pre-eclampsia and fetal growth restriction[J]. Ultrasound Obstet Gynecol202361(2):168-180.
[11]
Roberts JM, Hubel CA. The two stage model of preeclampsia: variations on the theme[J]. Placenta200930 Suppl A:S32-37.
[12]
Ashraf UM, Hall DL, Rawls AZ, et al. Epigenetic processes during preeclampsia and effects on fetal development and chronic health[J]. Clin Sci (Lond)2021135(19):2307-2327.
[13]
郑晓芳,魏宋荃,黄真轩,等. 子痫前期合并胎儿生长受限的妊娠结局及胎盘病理改变的研究[J/OL]. 中华产科急救电子杂志202312(2):85-92.
[14]
Odegård RA, Vatten LJ, Nilsen ST, et al. Preeclampsia and fetal growth[J]. Obstet Gynecol200096(6):950-955.
[15]
陈娟娟,孙雯,苏春宏,等. 子痫前期并发胎儿生长受限的临床特征及妊娠结局分析[J/OL]. 中华产科急救电子杂志202110(2):89-95.
[16]
Figueras F, Gratacós E. Update on the diagnosis and classification of fetal growth restriction and proposal of a stage-based management protocol[J]. Fetal Diagn Ther201436(2):86-98.
[17]
Gordijn SJ, Beune IM, Thilaganathan B, et al. Consensus definition of fetal growth restriction: a Delphi procedure[J]. Ultrasound Obstet Gynecol201648(3):333-339.
[18]
McCowan LM, Figueras F, Anderson NH. Evidence-based national guidelines for the management of suspected fetal growth restriction: comparison, consensus, and controversy[J]. Am J Obstet Gynecol2018218(2S):S855-868.
[19]
Poon LC, Shennan A, Hyett JA, et al. The International Federation of Gynecology and Obstetrics (FIGO) initiative on pre-eclampsia: a pragmatic guide for first-trimester screening and prevention[J]. Int J Gynaecol Obstet2019145 Suppl 1:1-33.
[20]
Andraweera PH, Lassi ZS. Cardiovascular risk factors in offspring of preeclamptic pregnancies-systematic review and meta-analysis[J]. J Pediatr2019208:104-113.e6.
[21]
Davis EF, Lazdam M, Lewandowski AJ, et al. Cardiovascular risk factors in children and young adults born to preeclamptic pregnancies: a systematic review[J]. Pediatrics2012129(6):e1552-1561.
[22]
Tenhola S, Rahiala E, Halonen P, et al. Maternal preeclampsia predicts elevated blood pressure in 12-year-old children: evaluation by ambulatory blood pressure monitoring[J]. Pediatr Res200659(2):320-324.
[23]
Jayet PY, Rimoldi SF, Stuber T, et al. Pulmonary and systemic vascular dysfunction in young offspring of mothers with preeclampsia[J]. Circulation2010122(5):488-494.
[24]
Davis EF, Lewandowski AJ, Aye C, et al. Clinical cardiovascular risk during young adulthood in offspring of hypertensive pregnancies: insights from a 20-year prospective follow-up birth cohort[J]. BMJ Open20155(6):e008136.
[25]
Nahum Sacks K, Friger M, Shoham-Vardi I, et al. Prenatal exposure to preeclampsia as an independent risk factor for long-term cardiovascular morbidity of the offspring[J]. Pregnancy Hypertens201813:181-186.
[26]
Youssef L, Miranda J, Paules C, et al. Fetal cardiac remodeling and dysfunction is associated with both preeclampsia and fetal growth restriction[J]. Am J Obstet Gynecol2020222(1):79.e1-79.e9.
[27]
Svigkou A, Katsi V, Kordalis VG, et al. The molecular basis of the augmented cardiovascular risk in offspring of mothers with hypertensive disorders of pregnancy[J]. Int J Mol Sci202425(10):5455.
[28]
Maher GM, O′Keeffe GW, Kearney PM, et al. Association of hypertensive disorders of pregnancy with risk of neurodevelopmental disorders in offspring: a systematic review and meta-analysis[J]. JAMA Psychiatry201875(8):809-819.
[29]
Dachew BA, Mamun A, Maravilla JC, et al. Pre-eclampsia and the risk of autism-spectrum disorder in offspring: meta-analysis[J]. Br J Psychiatry2018212(3):142-147.
[30]
Sun BZ, Moster D, Harmon QE, et al. Association of preeclampsia in term births with neurodevelopmental disorders in offspring[J]. JAMA Psychiatry202077(8):823-829.
[31]
Wang H, László KD, Gissler M, et al. Maternal hypertensive disorders and neurodevelopmental disorders in offspring: a population-based cohort in two Nordic countries[J]. Eur J Epidemiol202136(5):519-530.
[32]
Zhen Lim TX, Pickering TA, Lee RH, et al. Hypertensive disorders of pregnancy and occurrence of ADHD, ASD, and epilepsy in the child: a meta-analysis[J]. Pregnancy Hypertens202333:22-29.
[33]
Sverrisson FA, Bateman BT, Aspelund T, et al. Preeclampsia and academic performance in children: a nationwide study from Iceland[J]. PLoS One201813(11):e0207884.
[34]
Morsing E, Maršál K. Pre-eclampsia- an additional risk factor for cognitive impairment at school age after intrauterine growth restriction and very preterm birth[J]. Early Hum Dev201490(2):99-101.
[35]
Liu L, Lin Z, Zheng B, et al. Reduced intellectual ability in offspring born from preeclamptic mothers: a prospective cohort study[J]. Risk Manag Healthc Policy202013:2037-2046.
[36]
Zhu H, You X, Jing Y, et al. Maternal hypertensive disorder in pregnancy and childhood strabismus in offspring[J]. JAMA Netw Open20247(7):e2423946.
[37]
González-Rojas A, Valencia-Narbona M. Neurodevelopmental disruptions in children of preeclamptic mothers: pathophysiological mechanisms and consequences[J]. Int J Mol Sci202425(7):3632.
[38]
Hoodbhoy Z, Mohammed N, Nathani KR, et al. The impact of maternal preeclampsia and hyperglycemia on the cardiovascular health of the offspring: a systematic review and meta-analysis[J]. Am J Perinatol202340(4):363-374.
[39]
Li P, Xiong T, Hu Y. Hypertensive disorders in pregnancy and risk of asthma in offspring: a systematic review and meta-analysis[J]. BMJ Open202111(9):e046769.
[40]
Jia Y, He Y, Ai C, et al. Maternal hypertensive disorders during pregnancy and their link to childhood asthma: a systematic review and meta-analysis[J]. Front Pediatr202513:1659105.
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