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What a paediatric nephrologist should know about preeclampsia and why it matters

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Abstract

Preeclampsia is a protean syndrome causing a kidney disease characterised by hypertension and proteinuria, usually considered transitory and reversible after delivery. Its prevalence ranges from 3–5 to 10% if all the related disorders are considered. This narrative review, on behalf of the Kidney and Pregnancy Study Group of the Italian Society of Nephrology, focuses on three reasons why preeclampsia should concern paediatric nephrologists and how they can play an important role in its prevention, as well as in the prevention of future kidney and cardiovascular diseases. Firstly, all diseases of the kidney and urinary tract diagnosed in paediatric age are associated with a higher risk of adverse pregnancy-related outcomes, including preeclampsia. Secondly, babies with low birth weights (small for gestational age, born preterm, or both) have an increased risk of developing the full panoply of metabolic diseases (obesity, hypertension, early-onset cardiopathy and chronic kidney disease) and girls are at higher risk of developing preeclampsia when pregnant. The risk may be particularly high in cases of maternal preeclampsia, highlighting a familial aggregation of this condition. Thirdly, pregnant teenagers have a higher risk of developing preeclampsia and the hypertensive disorders of pregnancy, and should be followed up as high risk pregnancies. In summary, preeclampsia has come to be seen as a window on the future health of both mother and baby. Identification of subjects at risk, early counselling and careful follow-up can contribute to reducing the high morbidity linked with this disorder.

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Acknowledgements

We thank Susan Finnel for her careful language editing.

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Authors and Affiliations

  1. Néphrologie Et Dialyse, Centre Hospitalier Le Mans, 194 Avenue Rubillard, 72000, Le Mans, France

    Giorgina Barbara Piccoli, Massimo Torreggiani & Romain Crochette

  2. Azienda Ospedaliera Brotzu, Cagliari, Italy

    Gianfranca Cabiddu

  3. Department of Obstetrics and Gynecology, Città della Salute e della Scienza, Ospedale Sant’Anna, University of Torino, Turin, Italy

    Bianca Masturzo & Rossella Attini

  4. Epidemiology, Department of Clinical and Biological Sciences, University of Torino, Turin, Italy

    Elisabetta Versino

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  1. Giorgina Barbara Piccoli
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  2. Massimo Torreggiani
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  4. Gianfranca Cabiddu
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  5. Bianca Masturzo
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the Kidney and Pregnancy Study Group of the Italian Society of Nephrology (Giuseppe Gernone, Domenico Santoro, Gabriella Moroni, Linda Gammaro)

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Correspondence to Giorgina Barbara Piccoli.

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Piccoli, G.B., Torreggiani, M., Crochette, R. et al. What a paediatric nephrologist should know about preeclampsia and why it matters. Pediatr Nephrol 37, 1733–1745 (2022). https://doi.org/10.1007/s00467-021-05235-0

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