Child development after pregnancies complicated by low urinary estriol excretion and pre-eclampsia

A study is reported of maternal estriol excretion and subsequent child development in 16 pregnancies complicated by pre-eclampsia. Eight mothers with pre-eclampsia had abnormally low estriol excretion patterns and 4 of their children were small for dates. On follow-up examination, 3 of these children had major problems in development or function: microcephaly, seizure disorder, and developmental retardation with hyperactivity. Neurological abnormalities on follow-up examination were confined to children whose mothers had chronically low rather than precipitately dropping estriol levels. Eight mothers had normal estriol excretion with toxemia, and all 8 children weighed more than 2,500 grams and were normal on follow-up. The data suggest that if infants are of appropriate gestational ages when precipitate drops in maternal estriol excretion occur the infants should be delivered immediately because they do well. However, infants delivered after chronically low maternal estriol values are frequently defective.