Pre-eclampsia and high blood pressure in pregnancy

Impact of pre-eclampsia on children’s long-term health

Some people we talked to thought that their babies and children might have some ongoing health and developmental concerns. It was not always clear whether these were related to the mother having had pre-eclampsia or HELLP syndrome in her pregnancy or if this was an unrelated issue.
 
Several parents we spoke to were confident that there were no lasting effects from their illness on their child. Claire said her baby was where she should be developmentally and there has been no long-term impact: “she’s just a normal baby now”. Mairi said “it never once crossed my mind that there could be any effect on the baby” and her doctors had always been clear that the ‘problem’ of pre-eclampsia was to do with her, not her son. She had a follow-up meeting with her hospital doctors some months after the birth and thought that it would be good if it had been clarified then if there are likely to be any long-term health impacts for the child.
Others were concerned that their baby’s health or development had been impacted by their pre-eclampsia, because they had been born prematurely. Kay’s baby was born at 25 weeks and developed chronic lung disease. Her daughter was now aged four and Kay noticed that she sometimes “struggles to breathe, she tires easily, she doesn’t run around like other kids do”.
 
Check-ups on children’s health
 
Some babies had to have medical appointments at the hospital for some time after they were discharged. These appointments were not necessarily because the baby had known health problems, but were just for check-ups. Aileen had pre-eclampsia in both pregnancies. Her two children were born a year apart. She took each baby to a hospital clinic every three months until each child was two years old. Samantha X’s baby was prematurely born at 29 weeks and had some difficulties with feeding. She went to see the paediatric consultant more frequently, with 3 appointments in the last 6 months and expected those would continue for at least two years.
 
Sometimes these check-up appointments were reassuring for parents. However, some found it emotionally difficult to go back to the hospital where they and/or their baby had been very unwell. For Samantha X, taking her daughter back to hospital for the check-ups meant that “it all sort of comes flooding back and I think about it for days afterwards”.
 
Not everyone had follow-up appointments at hospital for their baby/child. Sometimes women felt comfortable with going to their GP if they had any concerns about their child’s health.
Health concerns for babies and children after pre-eclampsia
 
Some of the longer-term health concerns included:
  • Immune system and risk of infections
The immune systems of babies born prematurely are often not fully developed, meaning they are at higher risk of getting a serious infection. Kay was cautious, especially early on: “you can’t just go to [a supermarket]. I’m not taking my baby out to [a supermarket], there could be germs”. Added to this concern, she thought her daughter had not had all her immunisations because she was in hospital for so long and these would normally have been done at the GP surgery: “she got some injections; the hospital missed the next lot because, you know, she seemed to just be in no-man's-land because she'd been in hospital so long”.
  • Breathing and digestion problems
Sometimes the breathing (respiratory) and digestive systems of premature babies are not very developed. Kay’s daughter had chronic lung disease and came home on oxygen after three months in hospital. Since then, “her lungs still aren’t very good; she tires easy”. Paige knew her daughter’s lungs were less developed and this, coupled with higher risk of infections, made her very concerned about chest infections; the doctors “expected her [my baby] to be in hospital a lot just with a common cold, just with her immune system” but this has not been the case.
  • Cognitive and sensory development
Sometimes parents were told that premature babies may be later to do things (such as walk and talk) compared to babies the same age born at full-term. Sarah thought her baby was developmentally ‘behind’ for a while but has now “completely caught up”. A few parents thought their baby may have a ‘sensory processing disorder’. Josie wondered if this could be related to the fact that she wasn’t able to touch or hold her baby much when he was first born and needed looking after in Neonatal Intensive Care Unit (NICU). She had felt a lot of anxiety “about holding him because he was so small and attached to” medical equipment.
  • Appearance and size
A few women talked about their babies being quite small in size and weight. Paige thought her daughter was shorter than most of her peers who were born at full-term and also that she hasn’t lost any baby teeth yet. Kay sometimes had comments on her baby because “some days she honestly could audition for The Walking Dead [zombie television series], she’s so pale with purple, deep set eyes”.
However, it wasn’t always known whether their baby/child’s health problems were related or unrelated to their mother having had pre-eclampsia and/or being born prematurely. As Paige explained, “there’s a lot of things that I put down to being premature but then other people wouldn’t bat an eyelid on it”.
 
Parenting styles
 
Women often said that their experiences with pre-eclampsia have made them more anxious about the health of their children and of themselves (see also the section on lasting emotional impacts). Paige said she became very worried about health problems and is now more likely to seek medical help in case it is serious. She also has a lot of “anxiety” being apart from her daughter and that this is becoming especially difficult “now that she’s doing more and more things. She’s into everything, she's trying to walk, she's playing with toys, she's got her own little personality so leaving her to go into work is horrible because I don’t want to miss it”.
 
A few women thought though that their experiences had affected their approach to parenting in other ways too. Samantha X felt she and her husband are probably more relaxed parents because “every day we kind of think ‘oh my God, we’re so lucky she’s here’, because she so very nearly wasn’t”. She thought that worries about her baby’s health were likely to be quite normal and a “natural feeling for a new mother” rather than solely related to her experiences of having had pre-eclampsia.
Because a family history of pre-eclampsia is a risk factor for future generations developing the condition in their own pregnancies, Paige was conscious of this for her daughter’s future: “if she ended up with pre-eclampsia, would she go through what I went through?” Paige hoped though that her own experiences with pre-eclampsia would mean she would notice symptoms and there would be an opportunity to manage it sooner.

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