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Effect of hypertensive disorders of pregnancy on pubertal development in daughters and sons: a systematic review and meta-analysis


Hypertensive disorders of pregnancy (HDP) are a major cause of maternal and offspring morbidity and mortality worldwide. Several studies in recent years have focused on the link between HDP and pubertal development in offspring. The goal of this study was to synthesize the published literature on the effect of HDP on pubertal development in offspring by a systematic review and meta-analysis (PROSPERO 2021: CRD42020148736). A systematic literature search of several databases was conducted through December 2021, focusing on studies reporting pubertal development in offspring of women with and without HDP exposure. Primary outcomes of interest included offspring body mass index (BMI), height, waist and hip circumference, fat mass, pubarche, thelarche, and age at menarche. A total of 21 studies were finally included. Significantly higher values of BMI (SMD: 0.16 [0.11, 0.22]; p < 0.01) and waist circumference (SMD: 0.21 [0.14, 0.29]; p < 0.01) were found in offspring exposed to maternal HDP. In addition, a tendency of the early development of secondary sexual characteristics only in daughters was presented in offspring whose mothers were diagnosed with HDP. The findings imply a possible effect of HDP on pubertal development in offspring, especially for their BMI and waist circumference, which highlights the importance of focusing on adolescent developmental abnormalities in offspring exposed to HDP.

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We thank all our colleagues working in Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University.


The study was funded by the National Natural Science Foundation Program (Grant number: 81973137) and Hunan Provincial Key Research and Development Program (Grant number: 2018SK2062).

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ZY made substantial contributions with respect to: conception and design, acquisition of data, analysis and interpretation of data, drafting the article and revising it critically for important intellectual content, and final approval of the version to be published. XZ, ZG, SZ, XL, YC and CY made substantial contributions with respect to: analysis and interpretation of data, drafting the article and revising it critically for important intellectual content, and final approval of the version to be published. LC and TW are the guarantors for the study.

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Correspondence to Lizhang Chen or Tingting Wang.

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Yang, Z., Zhou, X., Gong, Z. et al. Effect of hypertensive disorders of pregnancy on pubertal development in daughters and sons: a systematic review and meta-analysis. J Hum Hypertens 37, 20–27 (2023).

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