Background: Preeclampsia is associated with long-term adverse health and developmental outcomes for children. However, it remains unclear how much of this association can be explained by unobserved familial confounding.
Methods: This was a retrospective, population-based cohort and discordant sibling study. We included all singleton children born at term between 2005-2016 in Victoria, Australia. Our primary outcomes were: (1) any illness-related hospitalisation or mortality before age six; and (2) diagnosed special needs or developmental vulnerability at school entry. Exposed and unexposed children were compared using generalised estimating equations, sibling cohorts discordant for preeclampsia exposure were compared using conditional logistic regression.
Results: Among 682,747 eligible children, 17,499 (2.6%) were exposed to preeclampsia. In our total cohort, preeclampsia was associated with an increased likelihood of hospitalisation or illness-related mortality before age six (aOR 1.08 [95% CI 1.05, 1.12]). However, after restricting our analysis to siblings discordant for preeclampsia exposure, we found no association (aOR 0.99 [95% CI 0.93, 1.06]; N=16,763 siblings). Preeclampsia was associated with a non-significant increased likelihood of developmental vulnerability or special needs (aOR 1.07 [95% CI 0.99, 1.16]), but among siblings, this trend was not observed (aOR 0.75 [95% CI 0.52, 1.07]).
Conclusions: Among children born at term, preeclampsia was associated with a small increase in childhood hospitalisation in the overall cohort, but not among siblings. Preeclampsia was not significantly associated with special needs or developmental vulnerability. Among term-born children, preeclampsia does not appear to be an independent driver of adverse early childhood health or developmental outcomes.