Prospective assessment of neurodevelopment in children following a pregnancy complicated by severe pre-eclampsia
Related Experiment Video
Updated: Mar 18, 2026
Modeling Encephalopathy of Prematurity Using Prenatal Hypoxia-ischemia with Intra-amniotic Lipopolysaccharide in Rats
Published on: November 20, 2015
Chelsie Warshafsky1, Jessica Pudwell1, Mark Walker2
1Department of Obstetrics and Gynecology, Kingston General Hospital, Queen's University, Kingston, Ontario, Canada.
Insights
Children born to mothers with severe pre-eclampsia (PE) showed neurodevelopmental delays up to age 5. Early screening for these children is crucial for long-term health outcomes.
Area of Science:
- Obstetrics and Gynecology
- Pediatric Neurology
- Developmental Pediatrics
Background:
- Severe pre-eclampsia (PE) is a serious pregnancy complication.
- Adverse pregnancy outcomes like PE are linked to potential neurodevelopmental issues in children.
Purpose of the Study:
- To investigate neurodevelopmental performance differences in children up to age 5 whose mothers experienced severe pre-eclampsia during pregnancy compared to controls.
- To identify potential long-term health implications for children exposed to severe PE in utero.
Main Methods:
- Prospective cohort study involving 129 mothers with PE-affected pregnancies and 140 matched normotensive controls.
- Neurodevelopmental performance assessed annually up to age 5 using the Ages and Stages Questionnaire (ASQ).
- Exclusion criteria included maternal history of chronic hypertension, diabetes, or renal disease.
Main Results:
- Children of mothers with severe PE showed a significantly greater number of ASQ categories failed at age 1.
- Significant differences in ASQ failures were observed in year 3, approaching significance in years 1 and 4.
- Preterm infants born to mothers with PE exhibited significantly more ASQ failures, particularly in gross motor skills.
- Maternal lifetime cardiovascular disease (CVD) risk score correlated positively with the number of ASQ categories failed.
Conclusions:
- Severe pre-eclampsia is associated with increased neurodevelopmental delays in children.
- Early neurodevelopmental screening and intervention are recommended for children exposed to severe PE.
- Further research is needed to elucidate the specific contributing factors to these delays.
Objective:
To prospectively examine whether children of women with a pregnancy affected by severe pre-eclampsia (PE), compared to children of women without a PE-affected pregnancy, have differences in neurodevelopmental performance up to 5 years of age.
Design:
Prospective cohort study.
Setting:
Tertiary care centre.
Participants:
Women were recruited following a PE-affected pregnancy. After each PE participant was recruited, the next normotensive woman without a prior history of PE and matched by parity, maternal age and race was invited to participate. Women with a history of chronic hypertension, diabetes or renal disease were excluded. Total enrolment included 129 PE-affected and 140 normotensive mothers.
Outcome Measures:
The primary outcome measure was failure of the Ages and Stages Questionnaire (ASQ). The ASQ was completed yearly, until age 5.
Results:
A significant difference was found in the proportion of ASQ categories failed in year 3 (p<0.05), and this approached significance in years 1 and 4 (p<0.10 and p<0.15, respectively). At year 1, the number of ASQ categories failed was significantly greater among children born to PE mothers. A subgroup analysis revealed that a significant proportion of PE children born preterm (<37 weeks) failed the ASQ in years 3 and 4 (p<0.05), and when failed, those who were preterm failed significantly more categories (p<0.05). A trend towards increased failure in the gross motor category was found. There was a significant positive correlation between maternal lifetime CVD risk score and number of ASQ categories failed at years 1 and 3 (p<0.05).
Conclusions:
Severe PE is associated with other adverse pregnancy outcomes, including intrauterine growth restriction and preterm birth, all of which are associated with increased neurodevelopment delays. Thus, PE indicates a need for early screening and intervention at the neurodevelopmental level to improve children's long-term health, with larger studies required to tease out contributing factors.
