Risk of Low Birth Weight Among Neonates Born to Mothers With Preeclampsia : A Systematic Review
DOI:
https://doi.org/10.21070/midwiferia.v12i2.1888Keywords:
Preeclampsia, Low Birth Weight, birth weight, fetal growth restriction, Preterm Infants, Neonatal OutcomesAbstract
Introduction Preeclampsia is a hypertensive disorder during pregnancy that can be associated with placental dysfunction, fetal growth restriction (FGR), preterm birth, and low birth weight (LBW). This systematic review aims to analyze the latest evidence regarding the risk of LBW in neonates born to mothers with preeclampsia and to identify factors that may influence it.
Methods The literature search was conducted based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 through PubMed, Scopus, ScienceDirect, and Web of Science for primary English-language articles published between January 2022 and December 2025. Studies that met the criteria involved mothers with preeclampsia or hypertensive disorders in pregnancy and reported LBW or birth weight. Five primary studies met the criteria and were included in the qualitative synthesis. The synthesis was carried out narratively because there was heterogeneity in study design, population, exposure definitions, and outcomes.
Results The results indicate that preeclampsia is associated with an increased risk of low birth weight (LBW), especially in early onset or severe cases, through placental perfusion disturbances, angiogenesis imbalance, fetal growth restriction, and medically indicated preterm delivery. Neonatal risk is also influenced by maternal comorbidities, gestational age at delivery, antenatal monitoring, and timing of delivery.
Discussion and Conclusion Early risk detection, fetal growth monitoring, proper maternal management, and coordination of obstetric and neonatal services are necessary to support the prevention of LBW-related morbidity
References
[1] Magee, L. A., Brown, M. A., Hall, D. R., Gupte, S., Hennessy, A., Karumanchi, S. A., Kenny, L. C., McCarthy, F., Myers, J., Poon, L. C., Rana, S., Saito, S., Staff, A. C., Tsigas, E., & von Dadelszen, P. (2022). The 2021 International Society for the Study of Hypertension in Pregnancy classification, diagnosis & management recommendations for international practice. Pregnancy Hypertension, 27, 148–169. https://doi.org/10.1016/j.preghy.2021.09.008
[2] Garovic, V. D., Dechend, R., Easterling, T., Karumanchi, S. A., McMurtry Baird, S., Magee, L. A., Rana, S., Vermunt, J. V., & August, P. (2022). Hypertension in pregnancy: Diagnosis, blood pressure goals, and pharmacotherapy: A scientific statement from the American Heart Association. Hypertension, 79(2), e21–e41. https://doi.org/10.1161/HYP.0000000000000208
[3] Jung, E., Romero, R., Yeo, L., Gomez-Lopez, N., Chaemsaithong, P., Jaovisidha, A., Gotsch, F., & Erez, O. (2022). The etiology of preeclampsia. American Journal of Obstetrics and Gynecology, 226(2 Suppl), S844–S866. https://doi.org/10.1016/j.ajog.2021.11.1356 [4] E. D. et al., “Pre-eclampsia,” Nat. Rev. Dis. Prim., vol. 9, no. 1, p. 8, 2023, doi: 10.1038/s41572-023-00417-6.
[4] Dimitriadis, E., Rolnik, D. L., Zhou, W., Estrada-Gutierrez, G., Koga, K., Lim, J. Y., Shirasuna, K., & others. (2023). Pre-eclampsia. Nature Reviews Disease Primers, 9, Article 8. https://doi.org/10.1038/s41572-023-00417-6
[5] World Health Organization. (2025, December 10). Pre-eclampsia. https://www.who.int/news-room/fact-sheets/detail/pre-eclampsia
[6] World Health Organization, United Nations Children’s Fund, United Nations Population Fund, World Bank Group, & United Nations Department of Economic and Social Affairs, Population Division. (2025). Trends in maternal mortality 2000 to 2023: Estimates by WHO, UNICEF, UNFPA, World Bank Group and UNDESA/Population Division. World Health Organization. https://www.who.int/publications/i/item/9789240108462
[7] Liu, Y., Li, N., An, H., Li, Z., Zhang, L., Li, H., Zhang, Y., & Ye, R. (2021). Impact of gestational hypertension and preeclampsia on low birthweight and small-for-gestational-age infants in China: A large prospective cohort study. The Journal of Clinical Hypertension, 23(4), 835–842. https://doi.org/10.1111/jch.14176
[8] Simbolon, D., Ningsih, L., Andriani, L., & Kamsiah. (2025). Is the incidence of low birth weight in Indonesia due to preeclampsia during pregnancy?: A meta-analysis. Media Gizi Indonesia, 20(3), 223–233. https://doi.org/10.20473/mgi.v20i3.223-233 [10] U. and W. H. Organization, “Low birthweight estimates: levels and trends 2000-2020,” 2023. [Online]. Available: https://data.unicef.org/resources/low-birthweight-report-2023/
[9] World Health Organization. (2022). WHO recommendations for care of the preterm or low-birth-weight infant. World Health Organization. https://www.who.int/publications/i/item/9789240058262
[10] United Nations Children’s Fund, & World Health Organization. (2023). UNICEF/WHO low birthweight estimates: Levels and trends 2000–2020. World Health Organization. https://data.unicef.org/resources/low-birthweight-report-2023/
[11] American College of Obstetricians and Gynecologists. (2022). Clinical guidance for the integration of the findings of the Chronic Hypertension and Pregnancy (CHAP) study. Obstetrics & Gynecology, 140(2), e26–e50. https://www.acog.org/clinical/clinical-guidance/practice-advisory/articles/2022/04/clinical-guidance-for-the-integration-of-the-findings-of-the-chap-study
[12] Ohuma, E. O., Moller, A. B., Bradley, E., Chakwera, S., Hussain-Alkhateeb, L., Lewin, A., Okwaraji, Y. B., Mahanani, W. R., Johansson, E. W., Lavin, T., Fernandez, D. E., Domínguez, G. G., de Costa, A., Cresswell, J. A., Krasevec, J., Lawn, J. E., Blencowe, H., Requejo, J., & Moran, A. C. (2023). National, regional, and global estimates of preterm birth in 2020, with trends from 2010: A systematic analysis. The Lancet, 402(10409), 1261–1271. https://doi.org/10.1016/S0140-6736(23)00878-4
[13] Karumanchi, S. A., & Thadhani, R. (2022). Preeclampsia: A placental angiogenic disorder with maternal and fetal consequences. Annual Review of Medicine, 73, 421–436.
[14] Staff, A. C. (2022). Long-term cardiovascular health after preeclampsia: Mechanistic links and clinical opportunities. Pregnancy Hypertension, 28, 37–45.
[15] Hutcheon, J. A., & Joseph, K. S. (2022). Epidemiology and clinical classification of hypertensive disorders of pregnancy in contemporary perinatal research. Best Practice & Research Clinical Obstetrics & Gynaecology, 85, 3–15.
[1] Magee, L. A., Brown, M. A., Hall, D. R., Gupte, S., Hennessy, A., Karumanchi, S. A., Kenny, L. C., McCarthy, F., Myers, J., Poon, L. C., Rana, S., Saito, S., Staff, A. C., Tsigas, E., & von Dadelszen, P. (2022). The 2021 International Society for the Study of Hypertension in Pregnancy classification, diagnosis & management recommendations for international practice. Pregnancy Hypertension, 27, 148–169. https://doi.org/10.1016/j.preghy.2021.09.008 DOI: https://doi.org/10.1016/j.preghy.2021.09.008
[2] Garovic, V. D., Dechend, R., Easterling, T., Karumanchi, S. A., McMurtry Baird, S., Magee, L. A., Rana, S., Vermunt, J. V., & August, P. (2022). Hypertension in pregnancy: Diagnosis, blood pressure goals, and pharmacotherapy: A scientific statement from the American Heart Association. Hypertension, 79(2), e21–e41. https://doi.org/10.1161/HYP.0000000000000208 DOI: https://doi.org/10.1161/HYP.0000000000000208
[3] Jung, E., Romero, R., Yeo, L., Gomez-Lopez, N., Chaemsaithong, P., Jaovisidha, A., Gotsch, F., & Erez, O. (2022). The etiology of preeclampsia. American Journal of Obstetrics and Gynecology, 226(2 Suppl), S844–S866. https://doi.org/10.1016/j.ajog.2021.11.1356 [4] E. D. et al., “Pre-eclampsia,” Nat. Rev. Dis. Prim., vol. 9, no. 1, p. 8, 2023, doi: 10.1038/s41572-023-00417-6. DOI: https://doi.org/10.1016/j.ajog.2021.11.1356
[4] Dimitriadis, E., Rolnik, D. L., Zhou, W., Estrada-Gutierrez, G., Koga, K., Lim, J. Y., Shirasuna, K., & others. (2023). Pre-eclampsia. Nature Reviews Disease Primers, 9, Article 8. https://doi.org/10.1038/s41572-023-00417-6 DOI: https://doi.org/10.1038/s41572-023-00417-6
[5] World Health Organization. (2025, December 10). Pre-eclampsia. https://www.who.int/news-room/fact-sheets/detail/pre-eclampsia
[6] World Health Organization, United Nations Children’s Fund, United Nations Population Fund, World Bank Group, & United Nations Department of Economic and Social Affairs, Population Division. (2025). Trends in maternal mortality 2000 to 2023: Estimates by WHO, UNICEF, UNFPA, World Bank Group and UNDESA/Population Division. World Health Organization. https://www.who.int/publications/i/item/9789240108462
[7] Liu, Y., Li, N., An, H., Li, Z., Zhang, L., Li, H., Zhang, Y., & Ye, R. (2021). Impact of gestational hypertension and preeclampsia on low birthweight and small-for-gestational-age infants in China: A large prospective cohort study. The Journal of Clinical Hypertension, 23(4), 835–842. https://doi.org/10.1111/jch.14176 DOI: https://doi.org/10.1111/jch.14176
[8] Simbolon, D., Ningsih, L., Andriani, L., & Kamsiah. (2025). Is the incidence of low birth weight in Indonesia due to preeclampsia during pregnancy?: A meta-analysis. Media Gizi Indonesia, 20(3), 223–233. https://doi.org/10.20473/mgi.v20i3.223-233 [10] U. and W. H. Organization, “Low birthweight estimates: levels and trends 2000-2020,” 2023. [Online]. Available: https://data.unicef.org/resources/low-birthweight-report-2023/ DOI: https://doi.org/10.20473/mgi.v20i3.223-233
[9] World Health Organization. (2022). WHO recommendations for care of the preterm or low-birth-weight infant. World Health Organization. https://www.who.int/publications/i/item/9789240058262
[10] United Nations Children’s Fund, & World Health Organization. (2023). UNICEF/WHO low birthweight estimates: Levels and trends 2000–2020. World Health Organization. https://data.unicef.org/resources/low-birthweight-report-2023/
[11] American College of Obstetricians and Gynecologists. (2022). Clinical guidance for the integration of the findings of the Chronic Hypertension and Pregnancy (CHAP) study. Obstetrics & Gynecology, 140(2), e26–e50. https://www.acog.org/clinical/clinical-guidance/practice-advisory/articles/2022/04/clinical-guidance-for-the-integration-of-the-findings-of-the-chap-study
[12] Ohuma, E. O., Moller, A. B., Bradley, E., Chakwera, S., Hussain-Alkhateeb, L., Lewin, A., Okwaraji, Y. B., Mahanani, W. R., Johansson, E. W., Lavin, T., Fernandez, D. E., Domínguez, G. G., de Costa, A., Cresswell, J. A., Krasevec, J., Lawn, J. E., Blencowe, H., Requejo, J., & Moran, A. C. (2023). National, regional, and global estimates of preterm birth in 2020, with trends from 2010: A systematic analysis. The Lancet, 402(10409), 1261–1271. https://doi.org/10.1016/S0140-6736(23)00878-4 DOI: https://doi.org/10.1016/S0140-6736(23)00878-4
[13] Karumanchi, S. A., & Thadhani, R. (2022). Preeclampsia: A placental angiogenic disorder with maternal and fetal consequences. Annual Review of Medicine, 73, 421–436.
[14] Staff, A. C. (2022). Long-term cardiovascular health after preeclampsia: Mechanistic links and clinical opportunities. Pregnancy Hypertension, 28, 37–45.
[15] Hutcheon, J. A., & Joseph, K. S. (2022). Epidemiology and clinical classification of hypertensive disorders of pregnancy in contemporary perinatal research. Best Practice & Research Clinical Obstetrics & Gynaecology, 85, 3–15.
[16] Ge, J., Gu, X., Jiang, S., Yang, L., Li, X., Jiang, S., Jia, B., Chen, C., Cao, Y., Lee, S. K., Zhao, X., Ji, Y., & Zhou, W. (2023). Impact of hypertensive disorders of pregnancy on neonatal outcomes among infants born at 24+0–31+6 weeks’ gestation in China: A multicenter cohort study. Frontiers in Pediatrics, 11, Article 1005383. https://doi.org/10.3389/fped.2023.1005383 DOI: https://doi.org/10.3389/fped.2023.1005383
[17] Li, Y., Chehab, R. F., Wang, E. Z., Susarla, S. M., Voong, C., Chen, H., Cabatu, M. C., Sorsby-Jones, H., & Zhu, Y. (2026). Global prevalence of hypertensive disorders of pregnancy: A scoping review and global perspective by country and region. Frontiers in Cardiovascular Medicine, 13, Article 1692590. https://doi.org/10.3389/fcvm.2026.1692590 DOI: https://doi.org/10.3389/fcvm.2026.1692590
[18] Hu, W., et al. (2024). Association between early-onset preeclampsia and fetal growth restriction: A population-based cohort study. Frontiers in Pediatrics, 12.
[19] Peahl, A. F., & Howell, J. D. (2021). The evolution of prenatal care delivery guidelines in the United States. American Journal of Obstetrics and Gynecology, 224(4), 339–347. https://doi.org/10.1016/j.ajog.2020.12.016 DOI: https://doi.org/10.1016/j.ajog.2020.12.016
[20] Beaulac, A., Cumyn, A., Côté, A.-M., & Caron, N. (2025). Hypertensive disorders of pregnancy: A narrative review. Canadian Journal of General Internal Medicine, 20(2), 57–68. https://doi.org/10.3138/cjgim.2024.0032 DOI: https://doi.org/10.3138/cjgim.2024.0032
[21] Masini, G., Foo, L. F., Tay, J., Wilkinson, I. B., Valensise, H., Gyselaers, W., & Lees, C. C. (2022). Preeclampsia has two phenotypes which require different treatment strategies. American Journal of Obstetrics and Gynecology, 226(2 Suppl), S1006–S1018. https://doi.org/10.1016/j.ajog.2020.10.052 DOI: https://doi.org/10.1016/j.ajog.2020.10.052
[22] World Health Organization. (2023). Low birthweight estimates: Levels and trends 2000–2020. World Health Organization & United Nations Children’s Fund.
[23] Lieskusumastuti, A. D., Setyorini, C., Hanifah, L., & Hapsari, I. A. (2022). Hubungan preeklamsia dengan kejadian berat badan lahir rendah (BBLR) pada ibu bersalin di RS PKU Muhammadiyah Delanggu. Jurnal Kebidanan Indonesia, 14(1), 139. https://doi.org/10.36419/jki.v14i1.770 DOI: https://doi.org/10.36419/jki.v14i1.770
[24] Ferawati, E., Kuswandi, K., & Karmila, N. (2023). Impact of severe preeclampsia on the incidence of low-birth-weight babies. Majalah Kedokteran Bandung, 55(4), 227–231. https://doi.org/10.15395/mkb.v55n4.3277 DOI: https://doi.org/10.15395/mkb.v55n4.3277
[25] Zuvarcan, D. A., Putra, D. A., & Martuti, S. (2024). Correlation between preeclampsia and infant low birth weight at Dr. Moewardi Hospital, Surakarta, Central Java, Indonesia. Journal of Maternal and Child Health, 9(1), 28–37. https://doi.org/10.26911/thejmch.2024.09.01.03 DOI: https://doi.org/10.26911/thejmch.2024.09.01.03
[26] Indriany, D. S., Yorita, E., Ekanugraheni, D., & Yanniarti, S. (2024). Preeclampsia is a risk factor for low birth weight (LBW) infants. Jurnal Ners dan Kebidanan Indonesia, 12(2), 151–167. https://doi.org/10.21927/jnki.2024.12(2).151-167 DOI: https://doi.org/10.21927/jnki.2024.12(2).151-167
[27] Nopiarmi, N. W. E., Tedjasulaksana, R., & Dewi, I. G. A. N. (2024). Pengaruh preeklampsia terhadap kejadian berat badan bayi lahir rendah di Rumah Sakit Umum Pusat Prof. Dr. I.G.N.G. Ngoerah Denpasar tahun 2022. Archive of Community Health, 11(3), 977–983.
[28] Dzakiyyah, S. A., Rahma, A., Salsabila, A., Agustina, D. S., Qamariah, S., Duarsa, A. M., & Cininta, N. I. (2025). Preeclampsia and preterm birth as predominant factors of low birth weight: Insights from a rural hospital in Indonesia. Folia Medica Indonesiana, 61(2), 196–203. https://doi.org/10.65346/2599-056X.2404 DOI: https://doi.org/10.65346/2599-056X.2404
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