Thursday, April 23, 2020

Association of preeclampsia in term births with neurodevelopmental disorders in offspring

Sun BZ, Moster D, Harmon QE, Wilcox AJ. Association of Preeclampsia in Term Births With Neurodevelopmental Disorders in Offspring. JAMA Psychiatry. Published online April 01, 2020. doi:10.1001/jamapsychiatry.2020.0306

Key Points

Question  Is preeclampsia linked to the neurodevelopment of offspring beyond its established association with cerebral palsy?

Findings  In this population-based birth cohort of 980 560 participants based on the Norwegian Medical Birth Registry, preeclampsia in term pregnancies was associated with an increased risk of cerebral palsy, autism, attention-deficit/hyperactivity disorder, epilepsy, and intellectual disability in offspring.

Meaning  After excluding the possible role of preterm delivery, preeclampsia in term pregnancies was associated with an increased risk of neurodevelopmental disorders among offspring.


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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