Association between Hypertensive Disorders of Pregnancy and Long-Term Neurodevelopmental Outcomes in the Offspring
Year: 2021
Type: article
Abstract: OBJECTIVE: The long-term impact of hypertensive disorders of pregnancy (HDP) exposure on offspring health is an emerging research area. The objective of this study was to evaluate the association between a maternal diagnosis of HDP (gestational hypertension and preeclampsia) and adverse neurodevelopmental outcomes in the offspring. STUDY DESIGN: This was a secondary analysis of two parallel multicenter clinical trials of thyroxine therapy for subclinical hypothyroid disorders in pregnancy. Women with singleton nonanomalous gestations diagnosed with subclinical hypothyroidism or hypothyroxinemia were randomized to thyroxine therapy or placebo. The primary outcome was child intelligence quotient (IQ) at 5 years of age. Secondary outcomes included several neurodevelopmental measures, including the Bayley-III cognitive, motor, and language scores at 12 and 24 months, Differential Ability Scales-II (DAS-II) scores at 36 months, the Conners' rating scales-revised at 48 months, and scores from the Child Behavior Checklist at 36 and 60 months. Thyroxine therapy did not influence neurodevelopment in either of the primary studies. Associations between neurodevelopment outcomes and maternal HDP were examined using univariable and multivariable analyses. RESULTS: = 0.002) differed significantly between the two groups. Maternal socioeconomic characteristics did not differ between the groups. After adjusting for potential confounders, there were no significant differences in any primary or secondary neurodevelopment outcome between offspring exposed to HDP and those unexposed. However, when dichotomized as low or high scores, we found higher rates of language delay (language scores <85: -1 standard deviation) at 2 years of age among offspring exposed to HDP compared with those unexposed (46.5 vs. 30.5%, adjusted odds ratio = 2.22, 95% confidence interval [CI]: 1.44-3.42). CONCLUSION: In this cohort of pregnant women, HDP diagnosis was associated with language delay at 2 years of age. However, other long-term neurodevelopmental outcomes in offspring were not associated with HDP. KEY POINTS: · No differences were found in neurodevelopment between offspring exposed to HDP and controls.. · Higher rates of language delay at 2 years of age were found in offspring exposed to HDP.. · The results did not differ when analysis was stratified by preterm birth..
Source: American Journal of Perinatology
DOI: 10.1055/a-1692-0659
Authors: Anna Palatnik, Lisa Mele, Brian M. Casey, Michael W. Varner, Yoram Sorokin, Uma M. Reddy, Ronald J. Wapner, John M. Thorp, George R. Saade, Alan T. N. Tita, Dwight J. Rouse, Baha Sibai, Maged M. Costantine, Brian M. Mercer, Jorge E. Tolosa, Steve N. Caritis, for the Eunice Kennedy Shriver National Institute of Child Health Human Development Maternal-Fetal Medicine Units Network, Bethesda, MD, USA
Institutions: Northwestern University, George Washington University, The University of Texas Southwestern Medical Center, University of Utah, University of Utah Health Care, Wayne State University, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Columbia University, University of North Carolina at Chapel Hill, The University of Texas Medical Branch at Galveston, University of Alabama at Birmingham, Brown University, The Ohio State University, Case Western Reserve University, Oregon Health & Science University, University of Pittsburgh
Language: English
Subfield: Obstetrics and Gynecology
Field: Medicine
Domain: Health Sciences
Open Access status: green
Awards: G1216570417, G1882602020, Eunice Kennedy Shriver NICHD Maternal Fetal Medicine Units Network, Maternal Fetal Medicine Units Network, NICHD Maternal Fetal Medicine Units Network, G2594613454, NICHD Maternal-Fetal Medicine Units (MFMU) Network, G284963502, G29782494, Maternal-Fetal Medicine Units Network, NICHD Maternal Fetal Medicine Units Network, Eunice Kennedy Shriver NICHD Maternal Fetal Medicine Units Network, Cooperative Multicenter Maternal Fetal Medicine Units Networks, G4027080872, G4238721334, Co-Operative Multicenter Trials in Obstetrics & Maternal Fetal Medicine, Data Coord Ctr-NICHD Cooperative Multicenter Maternal Medicine Units Research Net, Multicenter Network of Maternal Fetal Medicine Units, G4657398957, Maternal Fetal Medicine Units Network, Eunice Kennedy Shriver NICHD Maternal Fetal Medicine Units Network (U10), G6657596466, Brown/WIH Eunice Kennedy Shriver NICHD MFM Units Network Site, Maternal Fetal Medicine Network, NICHD Maternal Fetal Medicine Units Network, NICHD Materal Fetal Medicine Units Network, G8388394671, UofU Maternal-Fetal Medicine Units (MFMU) Network: Clinical Centers, Brown University/Women & Infants Hospital of Rhode Island (WIH) Center Application for the Eunice Kennedy Shriver NICHD Maternal Fetal Medicine Units Network, Maternal Fetal Medicine Units Network - Northwestern Study Center, Maternal-Fetal Medicine Units (MFMU) Network, Yale Clinical and Translational Science Award, Case Western Reserve University Center of the NICHD MFMU Network, Columbia University Maternal-Fetal Medicine Units Network Clinical Center, NICHD maternal fetal medicine units network, UNC MFMU: Advancing Perinatal Health via Definitive, Multi-Site Clinical Studies, Eunice Kennedy Shriver NICHD Maternal-Fetal Medicine Units (MFMU) Network (UG1), G922324195
OpenAlex ID: W3213318270