Reproductive health and metabolic profile features in adolescent girls born to mothers with preeclampsia

Introduction. Complicated pregnancy and delivery pose risks not only to maternal health but also to the offspring in later life. Preeclampsia (PE) has long-term effects on child development, increasing the risk of metabolic and endocrine disorders. However, studies investigating the impact of PE on the reproductive health in adolescent girls are limited, and existing data remain controversial, underscoring the relevance of the current study.

Aim: to assess the reproductive health and metabolic profile in adolescent girls depending on maternal PE during pregnancy and childbirth.

Materials and Methods. An ambispective cohort study was conducted. A total of 1,706 delivery records of women who gave birth to female infants in 2006, 2007 and 2008 were analyzed. From these, 184 adolescent girls who met the inclusion criteria were selected: singleton full-term spontaneous pregnancy, presence or absence of maternal PE, and live-born full-term females delivered between 2006 and 2008. Participants were divided into two groups: main group – 128 girls born to mothers with moderate or severe PE, control group comprised 56 girls whose mothers had an physiological course of pregnancy and delivery. A retrospective analysis of obstetric records and a prospective clinical assessment of adolescent girls were performed, including anthropometric evaluation with calculated standard deviation score (SDS) of body mass index (BMI), assessed menstrual and reproductive function, hormonal profiling, and ultrasound examination of the pelvic organs and mammary glands.

Results. In main group, a higher prevalence of dysmenorrhea (p = 0.027) and earlier age at menarche (p = 0.001) was observed compared to control group. At the same time, no significant inter-group differences in menstrual cycle regularity, menstrual blood loss, or time to cycle establishment (p > 0.05) were found. Evaluation of physical development revealed significant differences in BMI category distribution (p = 0.031). In main group, both underweight (20.3 % vs. 7.1 % in controls) and obesity (8.8 % vs. 3.6 %), including severe forms (class III and morbid obesity), were more frequently observed; the latter were absent in control group. Among girls in main group, fetal growth restriction (FGR) was observed significantly more frequently – 26.6 % vs. 0.0 % in controls, (p < 0.001), and both birth weight and birth length were significantly lower (p = 0.002 and p < 0.001, respectively). Incomplete menstrual cycle maturation (14.1 % vs. 10.7 %) and prolonged cycle establishment (> 3 years: 4.7 % vs. 0,0 %) tended to higher insignificant prevalence noted in main group (p = 0.176).

Conclusion. Maternal pregnancy complicated by preeclampsia is associated with altered reproductive health and metabolic profile in adolescent girls born to mothers with PE more frequently exhibiting primary dysmenorrhea, earlier menarche, and deviations in physical development such as bimodal distribution of BMI categories (increased prevalence of both underweight and obesity). These findings indicate a high-risk of menstrual dysfunction and metabolic disorders in girls born to mothers with PE, supporting a need for follow-up by a pediatric and adolescent gynecologist as well as development of personalized early prevention strategies.

1. Gestational Hypertension and Preeclampsia: ACOG Practice Bulletin, Number 222. American College of Obstetricians and Gynecologists. Obstet Gynecol. 2020;135(6):e237–e260. https://doi.org/10.1097/AOG.0000000000003891.

2. Clinical guidelines – Preeclampsia. Eclampsia. Edema, proteinuria and hypertensive disorders during pregnancy, childbirth and the postpartum period – 2024 (05.09.2024). [Klinicheskie rekomendacii – Preeklampsiya. Eklampsiya. Oteki, proteinuriya i gipertenzivnye rasstrojstva vo vremya beremennosti, v rodah i poslerodovom periode – 2024-2025-2026 (05.09.2024)]. Moscow: Ministerstvo zdravoohraneniya Rossijskoj Federacii, 2024. 53 p. (In Russ.). Available at: https://cr.minzdrav.gov.ru/view-cr/637_2. [Accessed: 10.03.2026].

3. Fox R., Kitt J., Leeson P. et al. Preeclampsia: risk factors, diagnosis, management, and the cardiovascular impact on the offspring. J Clin Med. 2019;8(10):1625. https://doi.org/10.3390/jcm8101625.

4. Bi S., Zhang L., Huang L. et al. Long-term effects of preeclampsia on metabolic and biochemical outcomes in offspring: What can be expected from a meta-analysis? Obes Rev. 2022;23(5):e13411. https://doi.org/10.1111/obr.13411.

5. Koulouraki S., Paschos V., Pervanidou P. et al. Short- and long-term outcomes of preeclampsia in offspring: review of the literature. Children (Basel). 2023;10(5):826. https://doi.org/10.3390/children10050826.

6. Sergeyev O.V., Nikitin A.I. Developmental origins of health and disease (DOHaD) and paternal origins of health and disease (POHaD). Multigenerational inheritance. Obstetrics, Gynecology and Reproduction. 2019;13(4):326–336. (In Russ.). https://doi.org/10.17749/2313-7347.2019.13.4.326-336.

7. Barker D.J., Gluckman P.D., Godfrey K.M. et al. Fetal nutrition and cardiovascular disease in adult life. Lancet. 1993;341(8850):938–41. https://doi.org/10.1016/0140-6736(93)91224-a.

8. Yelgina S.I., Nikulina E.N. Perinatal trace of the reproductive system in adolescent girls born prematurely. [«Perinatal'nyj sled» v reproduktivnoj sisteme u devushek-podrostkov, rozhdennyh nedonoshennymi]. MiD. 2018;19(2):26–31. (In Russ.). Available at: https://mednauki.ru/index.php/MD/article/view/228. [Accessed: 10.03.2026].

9. Pinheiro T.V., Brunetto S., Ramos J.G. et al. Hypertensive disorders during pregnancy and health outcomes in the offspring: a systematic review. J Dev Orig Health Dis. 2016;7(4):391–407. https://doi.org/10.1017/S2040174416000209.

10. Barron A., McCarthy C.M., O'Keeffe G.W. Preeclampsia and neurodevelopmental outcomes: potential pathogenic roles for inflammation and oxidative stress? Mol Neurobiol. 2021;58(6):2734–56. https://doi.org/10.1007/s12035-021-02290-4.

11. Davis E.F., Lazdam M., Lewandowski A.J. et al. Cardiovascular risk factors in children and young adults born to preeclamptic pregnancies: a systematic review. Pediatrics. 2012;129(6):e1552–e1561. https://doi.org/10.1542/peds.2011-3093.

12. Andraweera P.H., Lassi Z.S. Cardiovascular risk factors in offspring of preeclamptic pregnancies-systematic review and meta-analysis. J Pediatr. 2019;208:104–113.e6. https://doi.org/10.1016/j.jpeds.2018.12.008.

13. Yang S.-W., Oh M.-J., Park K.-V. et al. Risk of early Childhood obesity in offspring of women with preeclampsia: a population-based study. J Clin Med. 2021;10(16):3758. https://doi.org/10.3390/jcm10163758.

14. Malyshkina A.I., Batrak N.V., Fomina M.M., et al. Reproductive health of adolescent girls born prematurely: new forecasting opportunities. [Reproduktivnoe zdorov'e devochek-podrostkov, rozhdennyh nedonoshennymi: novye vozmozhnosti prognozirovaniya]. Ginekologiya. 2022;24(3):193–7. (In Russ.). https://doi.org/10.26442/20795696.2022.3.201552.

15. Alsnes I.V., Janszky I., Åsvold B.O. et al. Maternal preeclampsia and androgens in the offspring around puberty: a follow-up study. PLoS One. 2016;11(12):e0167714. https://doi.org/10.1371/journal.pone.0167714.

16. Ogland B., Nilsen S.T., Forman M.R. et al. Pubertal development in daughters of women with pre-eclampsia. Arch Dis Child. 2011;96(8):740–3. https://doi.org/10.1136/adc.2009.178434.

17. Vatten L.J., Romundstad P.R., Holmen T. L. et al. Intrauterine exposure to preeclampsia and adolescent blood pressure, body size, and age at menarche in female offspring. Obstet Gynecol. 2003;101(3):529–33. https://doi.org/10.1016/s0029-7844(02)02718-7.

18. Elesina I.G. Features of neuroendocrine regulation of menstrual function in adolescent girls with oligomenorrhea. [Osobennosti nejroendokrinnoj regulyacii menstrual'noj funkcii u devushek-podrostkov s oligomenoreej: Avtoref dis. ... kand. med. nauk]. Volgograd, 2017. 25 p. (In Russ.).

19. Sibirskaia E.V., Adamyan L.V., Loginova O.N. et al. Genetic aspects of uterine bleeding in puberty. [Geneticheskie aspekty matochnyh krovotechenij pubertatnogo perioda]. Problemy reprodukcii. 2016;22(5):86–92. (In Russ.). https://doi.org/10.17116/repro201622586-92.

20. D'Aloisio A.A., DeRoo L.A., Baird D.D. et al. Prenatal and infant exposures and age at menarche. Epidemiology. 2013;24(2):277–84. https://doi.org/10.1097/EDE.0b013e31828062b7.

21. Ros H.S., Lichtenstein P., Ekbom A. et al. Tall or short? Twenty years after preeclampsia exposure in utero: comparisons of final height, body mass index, waist-to-hip ratio, and age at menarche among women, exposed and unexposed to preeclampsia during fetal life. Pediatr Res. 2001;49(6):763–9. https://doi.org/10.1203/00006450-200106000-00008.

22. Tikhonova T.S., Sibirskaya E.V., Bogacheva A.A., Smolik L.Yu. Somatic health of women with a history of preeclampsia who delivered female infants. [Somaticheskoe zdorov'e zhenshchin s preeklampsiej v anamneze, rodivshih devochek[. Obstetrics, Gynecology and Reproduction. 2026;20(1):82–90. (In Russ.). https://doi.org/10.17749/2313-7347/ob.gyn.rep.2026.713.

23. Tikhonova T.S., Sibirskaya E.V. Clinical and anamnestic model for predicting menstrual cycle disorders in adolescent girls born to mothers with preeclampsia: computer program. [Kliniko-anamnesticheskaya model' prognozirovaniya narushenij menstrual'nogo cikla devushek-podrostkov, rozhdennyh u materej s preeklampsiej: programma dlya EVM]. Svidetel'stvo o gosudarstvennoj registracii programmy dlya EVM № 2025693585 ot 01.12.2025. (In Russ.).

24. Varley B.J., Henry A., Roberts L. et al. Intrauterine exposure to preeclampsia does not impair vascular health in children. Front Public Health. 2022;10:1071304. https://doi.org/10.3389/fpubh.2022.1071304.

25. Ogland B., Vatten L.J., Romundstad P.R. et al. Pubertal anthropometry in sons and daughters of women with preeclamptic or normotensive pregnancies. Arch Dis Child. 2009;94(11):855–9. https://doi.org/10.1136/adc.2008.150870.

26. Lunddorf L.L.H., Brix N., Ernst A. et al. Hypertensive disorders in pregnancy and timing of pubertal development in daughters and sons. Hum Reprod. 2020;35(9):2124–33. https://doi.org/10.1093/humrep/deaa147.

27. Clinical guidelines – Insufficient fetal growth requiring medical care for the mother (fetal growth restriction) – 2025 (21.11.2025). [Klinicheskie rekomendacii – Nedostatochnyj rost ploda, trebuyushchij predostavleniya medicinskoj pomoshchi materi (zaderzhka rosta ploda) – 2025 (21.11.2025). Moscow: Ministerstvo zdravoohraneniya Rossijskoj Federacii, 2025. 69 p. (In Russ.). Available at: https://cr.minzdrav.gov.ru/view-cr/722_2. [Accessed: 10.03.2026].