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Association of Preeclampsia in Term Births With Neurodevelopmental Disorders in Offspring
Bob Z Sun1, Dag Moster2,3, Quaker E Harmon4
1Department of Pediatrics, University of Washington, Seattle.
Insights
Preeclampsia in term pregnancies is associated with an increased risk of neurodevelopmental disorders in children, including ADHD, ASD, epilepsy, and intellectual disability. These findings suggest lasting effects beyond preterm delivery risks.
Area of Science:
- Neuroscience
- Developmental Pediatrics
- Obstetrics & Gynecology
Background:
- Preeclampsia is a serious pregnancy complication with known risks for offspring, primarily related to preterm birth.
- The association between preeclampsia and neurodevelopmental disorders in term infants is less understood.
Purpose of the Study:
- To investigate the association between preeclampsia in term pregnancies and a spectrum of adverse neurodevelopmental outcomes in offspring.
- To determine if preeclampsia poses risks to neurodevelopment independent of preterm birth.
Main Methods:
- A prospective, population-based cohort study using Norwegian registry data.
- Included singleton children born at term between 1991 and 2009, followed up to age 5.
- Analyzed associations between maternal preeclampsia and cerebral palsy, ADHD, ASD, epilepsy, intellectual disability, and sensory impairments.
Main Results:
- The study included nearly one million term-born children, with 2.9% exposed to preeclampsia.
- Preeclampsia exposure was linked to increased risks of attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorder (ASD), epilepsy, and intellectual disability.
- An association was also observed between preeclampsia and cerebral palsy, though not statistically significant in this analysis.
Conclusions:
- Preeclampsia occurring in term pregnancies may have significant and lasting adverse effects on child neurodevelopment.
- These findings highlight potential risks beyond those associated with preterm delivery.
- Further research is warranted to understand the mechanisms and implications of these associations.
Importance:
Preeclampsia during pregnancy has been linked to an increased risk of cerebral palsy in offspring. Less is known about the role of preeclampsia in other neurodevelopmental disorders.
Objective:
To determine the association between preeclampsia and a range of adverse neurodevelopmental outcomes in offspring after excluding preterm births.
Design, Setting, And Participants:
This prospective, population-based cohort study included singleton children born at term from January 1, 1991, through December 31, 2009, and followed up through December 31, 2014 (to 5 years of age), using Norway's Medical Birth Registry and linked to other demographic, social, and health information by Statistics Norway. Data were analyzed from May 30, 2018, to November 17, 2019.
Exposures:
Maternal preeclampsia.
Main Outcomes And Measures:
Associations between preeclampsia in term pregnancies and cerebral palsy, attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorder (ASD), epilepsy, intellectual disability, and vision or hearing loss using multivariable logistic regression.
Results:
The cohort consisted of 980 560 children born at term (48.8% female and 51.2% male; mean [SD] gestational age, 39.8 [1.4] weeks) with a mean (SD) follow-up of 14.0 (5.6) years. Among these children, 28 068 (2.9%) were exposed to preeclampsia. Exposed children were at increased risk of ADHD (adjusted odds ratio [OR], 1.18; 95% CI, 1.05-1.33), ASD (adjusted OR, 1.29; 95% CI, 1.08-1.54), epilepsy (adjusted OR, 1.50; 95% CI, 1.16-1.93), and intellectual disability (adjusted OR, 1.50; 95% CI, 1.13-1.97); there was also an apparent association between preeclampsia exposure and cerebral palsy (adjusted OR, 1.30; 95% CI, 0.94-1.80).
Conclusions And Relevance:
Preeclampsia is a well-established threat to the mother. Other than the hazards associated with preterm delivery, the risks to offspring from preeclampsia are usually regarded as less important. This study's findings suggest that preeclampsia at term may have lasting effects on neurodevelopment of the child.
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