EUROPEAN JOURNAL OF PEDIATRICS, cilt.185, sa.4, 2026 (SCI-Expanded, Scopus)
Background Preeclampsia (PE) is associated with long-term cardiovascular risks in offspring, but its subclinical cardiac impact remains underexplored. This study aimed to evaluate the long-term cardiac function in children born to preeclamptic mothers using conventional and two-dimensional speckle tracking echocardiography (2D-STE). Methods In this prospective cross-sectional study, 48 offspring (aged 2-12 years) of preeclamptic pregnancies were compared with 48 age- and sex-matched controls. Standard echocardiographic measurements and advanced myocardial strain parameters (total global longitudinal strain [TGLS], total global circumferential strain [TGCS]) were assessed. Subgroup analyses were performed based on the timing of PE onset (early vs. late). Statistical significance was set at p < 0.05. Results No significant differences were observed in conventional echocardiographic systolic indices (EF, FS, TAPSE). However, the mitral E/A ratio was significantly lower in the PE group (p = 0.0099), suggesting early diastolic dysfunction. 2D-STE revealed significantly reduced total GLS (- 25.8 +/- 1.5 vs - 28.3 +/- 2.3, p < 0.0001) and mid-level GCS (- 25.0 +/- 3.5 vs - 26.9 +/- 4.4, p = 0.0175) in the PE group. No differences in strain parameters were observed between early-onset and late-onset PE subgroups. Although anthropometric measures (weight and height) were lower in the PE group, SDS values were not statistically different. Conclusions: Children exposed to PE in utero demonstrate subclinical alterations in left ventricular systolic and diastolic function, detectable only via advanced echocardiographic methods. Conventional echocardiographic parameters may fail to detect these early functional impairments. Long-term cardiac monitoring using 2D-STE could be crucial for this at-risk population, regardless of PE onset timing.