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Neurological function in children born to preeclamptic and hypertensive mothers - A systematic review
Ernesto A Figueiró-Filho1, Lauren E Mak2, James N Reynolds2
1Department of Biomedical and Molecular Sciences, Queen's University, Kingston, ON, Canada; Faculty of Medicine, Federal University of Mato Grosso do Sul, (FAMED-UFMS), Campo Grande, MS, Brazil; Centre for Neuroscience Studies, Queen's University, Kingston, ON, Canada.
Insights
Children born to mothers with preeclampsia (PE-F1s) exhibit developmental differences. This review highlights that PE-F1s represent an at-risk group for neurological and cognitive deviations, warranting further investigation.
Area of Science:
- Neuroscience
- Developmental Biology
- Obstetrics
Background:
- Offspring of preeclampsia (PE) pregnancies (PE-F1s) display cognitive, behavioral, and mood differences.
- Preeclampsia-related angiokine dysregulation may stem from fetal-intrinsic gene dysregulation.
- This suggests fetal brain development is impacted by mechanisms beyond placental factors.
Purpose of the Study:
- To systematically review neurological measurements differentiating brain function in PE-F1s compared to controls.
- To investigate if fetal-intrinsic mechanisms contribute to neurodevelopmental deviations in PE-F1s.
Main Methods:
- Systematic literature search up to June 2017 in MEDLINE, PsycINFO, EMBASE, and grey literature.
- Inclusion and exclusion criteria applied to identify relevant studies.
Main Results:
- 27 studies out of 464 met the criteria, reporting on neurological function in PE-F1s.
- Strong evidence supports behavioral and cognitive deviations in PE-F1s.
- Only three studies utilized magnetic resonance imaging (MRI) to assess brain measurements.
Conclusions:
- Behavioral and cognitive deviations in PE-F1s are well-supported by current literature.
- PE-F1s should be recognized as an at-risk pediatric population for brain development.
- Further research on PE-F1s, potentially stratified by maternal factors, is recommended.
Background:
Offspring whose mothers developed preeclampsia (PE-F1s) show developmental effects that are now being identified, such as cognitive, behavioural, and mood differences compared to offspring from non-complicated pregnancies. We hypothesize that the progressive angiokine dysregulation associated with development of preeclampsia (PE) reflects gene dysregulation in pre-implantation conceptuses, and manifests in all developing fetal tissues rather than exclusively to the placenta. This hypothesis predicts that fetal cerebrovascular and brain development are deviated by fetal-intrinsic, brain-based mechanisms during what is currently considered a placentally-induced maternal disease. Due to our initial results from brain-imaging and cognitive screening in a child pilot PE-F1 cohort, we developed this systematic review to answer the question of whether any consistent neurological measurements have been found to discriminate between brain functions in offspring of mothers who experienced a hypertensive pregnancy vs. offspring of mothers that did not.
Methods:
Relevant studies were searched systematically up to June 2017 in MEDLINE, PsycINFO, EMBASE and the grey literature.
Results:
Following predetermined inclusion and exclusion criteria, our search identified 27 out of 464 studies reporting on neurological function in offspring born to preeclamptic and hypertensive mothers.
Conclusion:
The current literature strongly supports the conclusion of the behavioural and cognitive deviations in PE-F1s. However, only three studies associated their findings with brain measurements via magnetic resonance imaging (MRI) in both healthy and at-risk pediatric populations. PE-F1s should be identified as an at-risk pediatric population during brain development and studied further as a defined group, perhaps stratified by maternal plasma angiokine levels.
