Hypertensive disorders in pregnancy and risk of asthma in the offspring: a systematic review and meta-analysis

Calzada N.D.; Barba C.A.; Quispe-Vicuña C.; Sandoval-Ato R.H.; Rodriguez-Saldaña C.A.; Yangali-Vicente J.; Rivera-Lozada O.; Barboza J.J. · Frontiers in Medicine (2026) · DOI: 10.3389/fmed.2026.1739697

Resumen

Background – Hypertensive disorders of pregnancy (HDP), including preeclampsia, gestational hypertension, and eclampsia, are common pregnancy complications that may have long-term consequences for offspring health. Emerging evidence suggests a potential link between maternal hypertension and childhood asthma, though findings remain inconsistent. This systematic review and meta-analysis aimed to synthesize the existing evidence on the association between HDP and asthma risk in offspring. Methods – A comprehensive search of PubMed, Scopus, Web of Science, and EMBASE was conducted from database inception to 3 December 2024, restricted to peer-reviewed published studies. The eligibility criteria followed the PICOS framework. Observational studies (cohort, case–control, cross-sectional) assessing the association between HDP and asthma in offspring were included. Effect measures were converted to odds ratios (OR) with 95% confidence intervals (CI), and a meta-analysis was performed using random- and fixed-effects models. Heterogeneity was assessed jointly with Cochran’s Q test (p < 0.10) and the I2 statistic, and publication bias was examined through funnel plots and Egger’s test. Results – Twenty studies encompassing over three million mother–infant pairs were included. The pooled OR for asthma risk in offspring of mothers with HDP was 1.14 (95% CI: 1.07–1.21), indicating a significant association. Subgroup analyses revealed a positive association with both preeclampsia (OR: 1.20; 95% CI: 1.12–1.28) and gestational hypertension (OR: 1.18; 95% CI: 1.02–1.36). Heterogeneity was high in some subgroups, such as gestational hypertension (I2 = 92.6%; p < 0.0001), suggesting variability across studies. As a secondary outcome, the association between HDP and wheezing in the offspring was assessed. The pooled OR was 1.07 (95% CI: 0.99–1.17), not reaching statistical significance, although positive trends were observed in some subtypes. Conclusion – Maternal HDP is associated with an approximately 14–20% increased risk of asthma in offspring, highlighting the need for targeted early-life monitoring and intervention strategies. Further research is warranted to elucidate underlying mechanisms and optimize maternal–fetal health outcomes. Systematic review registration – IS: CRD420251000229. Copyright

Instituciones: Universidad Privada Antenor Orrego; Universidad de Huánuco; Universidad Señor de Sipán