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[A prospective birth cohort study on the association between gestational blood pressure and neurodevelopment in
1The Institute of Environmental Medicine, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China.
Insights
Elevated gestational blood pressure, including its mean, cumulative levels, and variability, is linked to lower neurodevelopmental scores in 2-year-old children. This association highlights the importance of monitoring maternal blood pressure for child development outcomes.
Area of Science:
- Obstetrics and Gynecology
- Pediatric Neurology
- Developmental Pediatrics
Background:
- Gestational blood pressure is a critical indicator of maternal and fetal health.
- Neurodevelopmental outcomes in early childhood are influenced by various prenatal factors.
- Understanding the impact of maternal blood pressure on child neurodevelopment is crucial for public health.
Purpose of the Study:
- To investigate the association between various measures of gestational blood pressure and neurodevelopmental indices in 2-year-old children.
- To analyze the relationship between mean, cumulative, and variability of blood pressure during pregnancy and child neurodevelopment.
- To identify specific trimesters or blood pressure parameters most strongly associated with neurodevelopmental outcomes.
Main Methods:
- Utilized data from the "Wuhan Healthy Baby Birth Cohort" including 3,754 mother-infant pairs.
- Calculated mean, cumulative, and variability (SD, CV, VIM) of blood pressure throughout pregnancy and by trimester.
- Assessed neurodevelopment using the Mental Development Index (MDI) and Psychomotor Development Index (PDI) at age two.
- Employed multivariate linear regression and generalized estimation equation for statistical analysis.
Main Results:
- Higher mean, cumulative, and variability of gestational blood pressure (systolic, diastolic, pulse pressure) were negatively associated with MDI and PDI scores.
- Average systolic blood pressure in all trimesters showed a negative association with MDI/PDI.
- Negative associations between cumulative blood pressure and neurodevelopment were primarily observed in the first trimester.
- Blood pressure variation during pregnancy showed negative associations with MDI/PDI mainly in the second and third trimesters.
Conclusions:
- Gestational blood pressure parameters, including mean levels and variability, are negatively associated with neurodevelopmental indices in 2-year-old children.
- The findings underscore the potential impact of maternal hypertension during pregnancy on cognitive and psychomotor development.
- Further research is warranted to explore underlying mechanisms and clinical implications.
Abstract:
Objective: To investigate the association between gestational blood pressure and neurodevelopment in 2-year-old children. Methods: Based on the"Wuhan Healthy Baby Birth Cohort", 3 754 mother-infant pairs were enrolled in this study. Based on multiple blood pressure measurements during pregnancy, the mean, cumulative, and variability of blood pressure throughout the entire pregnancy and each trimester were calculated. Blood pressure variability was evaluated using standard deviation (SD), coefficient of variability (CV), and variability independent of mean (VIM). Follow-up testing of neurodevelopment in infants and young children at the age of two was conducted to obtain the Mental Development Index (MDI) and the Psychomotor Development Index (PDI). The multivariate linear regression and generalized estimation equation were used to analyze the association between gestational blood pressure data and neurodevelopmental index. Results: The age of 3 754 pregnant women was (29.1±3.6) years, with a pre-pregnancy BMI of (20.9±2.7) kg/m² and a gestational age of (39.3±1.2) weeks. The birth weight of 3 754 children was (3 330.9±397.7) grams, and the birth length was (50.3±1.6) centimeters. The results of the multivariate linear regression analysis showed that after adjusting for relevant confounding factors, the mean blood pressure, cumulative blood pressure, standard deviation of blood pressure, coefficient of variation of blood pressure, independent blood pressure variability of systolic blood pressure, diastolic blood pressure, and pulse pressure throughout pregnancy were negatively associated with the MDI and PDI scores of 2-year-old children. The analysis results of the generalized estimation equation showed that after adjusting for relevant confounding factors, the average systolic blood pressure in the first, second, and third trimesters was negatively associated with MDI/PDI. The negative association between cumulative blood pressure and MDI/PDI was only found in the first trimester. The negative association between blood pressure variation during pregnancy and MDI/PDI was mainly concentrated in the second and third trimesters. Conclusion: There is a negative association between gestational blood pressure and the neurodevelopmental index of 2-year-old children.
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