title: Is preeclampsia associated with fetal malformation? A review and report of original research.
abstract: OBJECTIVE
  To examine fetal malformations in mother-infant pairs with and without pregnancy-related hypertension.
  
  
  METHODS
  This was an observational, population-based study of women delivering a singleton at our hospital. Specific fetal malformations identified in women with gestational hypertension or preeclampsia were compared to those without pregnancy-related hypertension. Women with chronic hypertension, superimposed preeclampsia on chronic hypertension and pregestational diabetes were excluded.
  
  
  RESULTS
  Between March 2002 and December 2012, a total of 151 997 women delivered, and 10 492 (7%) had preeclampsia, 4282 (3%) had gestational hypertension and 137,223 (90%) were referent normotensive controls. Women with preeclampsia were significantly more likely to deliver infants with malformations when compared to normotensive controls (2.5% versus 1.6%, p < 0.001), whereas women with gestational hypertension were not (1.9% versus 1.6%, p = 0.16). The overall risk for fetal malformation associated with preeclampsia remained significant following logistic regression for age, race, parity and maternal body-habitus (adjusted OR 1.5; 95% CI: 1.3-1.7). Only single-organ system malformations - microcephaly and hypospadias - remained associated with preeclampsia (p < 0.001), and fetal growth restriction was a co-factor for both.
  
  
  CONCLUSIONS
  Preeclampsia was associated with increased rates of fetal malformations when compared to normotensive women - specifically microcephaly and hypospadias. These associations appear predominantly as a consequence of impaired fetal growth.
authors.affiliation: a Department of Obstetrics and Gynecology and.
authors.forename: David B
authors.initials: DB
authors.lastname: Nelson
authors.affiliation: b Department of Pediatrics , University of Texas Southwestern Medical Center at Dallas , Dallas , TX , USA.
authors.forename: Lina F
authors.initials: LF
authors.lastname: Chalak
authors.affiliation: a Department of Obstetrics and Gynecology and.
authors.forename: Donald D
authors.initials: DD
authors.lastname: McIntire
authors.affiliation: a Department of Obstetrics and Gynecology and.
authors.forename: Kenneth J
authors.initials: KJ
authors.lastname: Leveno
mesh_terms: D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D000013:Congenital Abnormalities / Q000209:etiology*; D016208:Databases, Factual; D005260:Female; D006801:Humans; D046110:Hypertension, Pregnancy-Induced; D016015:Logistic Models; D011225:Pre-Eclampsia; D011247:Pregnancy; D012307:Risk Factors; D055815:Young Adult
keywords: Fetal malformation; gestational hypertension; preeclampsia