Hypertensive disorders of pregnancy and emotional and behavioural problems in children: a longitudinal
Berihun Assefa Dachew1,2, James G Scott3,4,5, Abdullah Mamun6
1Institute for Social Science Research, The University of Queensland, 80 Meiers Road, Indooroopilly, Brisbane, QLD, 4068, Australia. b.dachew@uqconnect.edu.au.
Insights
Children born to mothers with preeclampsia face higher risks of behavioral and emotional issues, particularly when reported by teachers. Parent reports did not show the same associations, highlighting the need for multiple perspectives.
Area of Science:
- Obstetrics and Gynecology
- Child Psychology
- Epidemiology
Background:
- Hypertensive disorders of pregnancy (HDP) are linked to adverse offspring health outcomes.
- Understanding the long-term effects of maternal HDP on child development is crucial.
Purpose of the Study:
- To investigate the association between maternal hypertensive disorders of pregnancy (HDP) and emotional and behavioral problems in offspring at age 11.
- To compare teacher and parent reports of these problems.
Main Methods:
- Utilized data from the Avon Longitudinal Study of Parents and Children (ALSPAC).
- Assessed emotional and behavioral problems using the Strengths and Difficulties Questionnaire (SDQ) completed by parents and teachers.
- Analyzed data from 7196 parents and 7411 teachers.
Main Results:
- Maternal preeclampsia was associated with increased teacher-reported behavioral difficulties (RR=1.62) and internalizing problems, including peer and emotional problems.
- No significant associations were found between preeclampsia or gestational hypertension and parent-reported problems.
- Teacher reports indicated a higher risk of behavioral and internalizing issues in children exposed to preeclampsia.
Conclusions:
- Preeclampsia exposure in mothers is linked to a greater risk of behavioral and emotional difficulties in children, as perceived by teachers.
- The discrepancy between teacher and parent reports underscores the importance of multi-informant assessments for child behavioral problems.
- Findings suggest that the manifestation of these difficulties may vary depending on the reporting context.
Abstract:
There is evidence that offspring of mothers who have hypertensive disorders of pregnancy (HDP) are at increased risk of adverse health outcomes. This study aims to examine the association between maternal HDP and emotional- and behavioural problems in offspring at age 11 years as reported by teachers and parents. The current study is based on the Avon Longitudinal Study of Parents and Children (ALSPAC), a prospective, population-based study that has followed a cohort of offspring since their mothers were pregnant. Childhood emotional- and behavioural problems were measured using the Strengths and Difficulties Questionnaire (SDQ), completed by parents (n = 7196) and the child's teacher (n = 7411). Maternal preeclampsia, but not gestational hypertension, was associated with teacher-reported total behavioural difficulties (RR = 1.62; 95% CI 1.03-2.52) and internalising problems in children [peer problems (RR = 1.48; 95% CI 1.06-2.08) and emotional problems (RR = 1.68; 95% CI 1.13-2.51)]. No associations between preeclampsia and/or gestational hypertension and parent-reported emotional- and behaviour problems were observed. Our study showed that children exposed to preeclampsia had higher risk of teacher-reported total behavioural difficulties and internalising problems compared with unexposed children. The findings suggest emotional- and behavioural difficulties may not be evident in all settings, hence the importance of collecting evidence from multiple informants.
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