Abstract Background To estimate the association of hypertensive disorders of pregnancy (HDP) with offspring kidney function in adolescence and young adulthood in individuals born preterm with very low birth weight. Methods Secondary analysis of data from a prospective cohort study of individuals born preterm with very low or extremely low birth weight (< 1500 g). The 213 participants were assessed at 14–15 and 19–23 years of age. Outcomes were estimated glomerular filtration rate (eGFR) and first-morning urine albumin-to-creatinine ratio (ACR). We estimated the relationships with multivariable generalized linear models informed by directed acyclic graphs. Causal mediation analysis was also performed to evaluate if adolescent kidney function indirectly mediated the effect of HDP on young adulthood kidney function. Results Thirty-seven percent ( n = 79) were exposed to HDP. Kidney function in adolescence was associated with kidney function in young adulthood (eGFR adjusted β 0.48 mL/min/1.73 m 2 , 95% CL 0.21–0.75; ACR adjusted β 0.19 mg/g, 95% CL 0.15–0.24). There was no significant association between HDP and kidney function in both adolescence and young adulthood. There was also no statistically significant causal mediation effect of HDP on young adulthood kidney function indirectly through adolescent kidney function. Conclusions We found no significant association between HDP and offspring kidney function in adolescence and young adulthood and no evidence of mediation through adolescent kidney function. Next steps in this research may look to investigate the relationship of severity of prematurity on offspring kidney function, as HDPs are a factor in premature births and the degree of prematurity. Graphical Abstract
Kelly et al. (2026) studied this question.