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Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Hypertensive diseases of pregnancy predict parent-reported difficult temperament in infancy
Monique Robinson1, Wendy H Oddy, Andrew J O Whitehouse
1Telethon Institute for Child Health Research, Centre for Child Health Research, The University of Western Australia, Perth, Australia. moniquer@ichr.uwa.edu.au
Insights
Hypertensive diseases of pregnancy, including gestational hypertension and preeclampsia, are linked to infant behavioral development. Mothers with these conditions were more likely to report difficult infant temperaments in the first year of life.
Area of Science:
- Perinatal health
- Child neurodevelopment
- Maternal health
Background:
- Hypertensive disorders of pregnancy are associated with later neurodevelopmental issues.
- Previous studies focused on childhood and adulthood outcomes.
- The impact on infant behavior requires further investigation.
Purpose of the Study:
- To determine if hypertensive diseases of pregnancy affect infant behavior.
- To investigate behavioral development in the first year of life.
- To link maternal conditions to infant temperament.
Main Methods:
- Prospective cohort study of 2,785 pregnancies.
- Maternal temperament assessment at 1 year using the Toddler Temperament Scale.
- Multivariable logistic regression adjusted for confounders.
Main Results:
- Gestational hypertension increased the odds of difficult infant temperament (OR 1.36).
- Preeclampsia significantly increased the odds of difficult infant temperament (OR 2.23).
- These associations were observed in the first year of life.
Conclusions:
- The association between maternal hypertensive diseases and child behavioral development starts in infancy.
- Early infant temperament may be influenced by prenatal hypertensive conditions.
- This highlights the importance of monitoring infant behavior following hypertensive pregnancies.
Objective:
Recent research has linked hypertensive diseases of pregnancy with adverse neurodevelopmental outcomes in childhood and adulthood. This study aimed to establish whether such effects are observed in infancy.
Methods:
This was a prospective pregnancy cohort study of 2,785 pregnancies with complete data on hypertensive diseases of pregnancy. Mothers completed a validated Australian adaptation of the Toddler Temperament Scale when the children were 1 year of age (n = 2,384). Algorithms were used to classify children as difficult, slow to warm up, intermediate high, intermediate low, or easy, on the basis of their temperament scores. We then grouped difficult and intermediate-high infants together and compared them with easy, intermediate-low, and slow-to-warm-up infants. We used a multivariable logistic regression model and adjusted for known biomedical, sociodemographic, and psychological factors from the pre- and postnatal period that may influence child behavioral development.
Results:
After adjusting for confounders, mothers who were diagnosed with gestational hypertension (odds ratio [OR], 1.36; 95% confidence interval [CI], 1.06-1.75) or preeclampsia (OR, 2.23; 95% CI, 1.18-4.23) were more likely to report that their infants were in the difficult or intermediate-high classifications in the first year of life compared with infants born to mothers without gestational hypertension or preeclampsia.
Conclusion:
These data suggest that the link between maternal hypertensive diseases of pregnancy and child behavioral development begins in the first year of life.
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