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Hypertensive disorders in pregnancy and child development at 36 months in the All Our Families prospective cohort study

Hypertensive disorders in pregnancy (HDP) are associated with increased risk of offspring neurodevelopmental disorders, suggesting long-term adverse impacts on fetal brain development. However, the relationship between HDP and deficits in general child development is unclear. Our objective was to as...

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Autores principales: Scime, Natalie V., Hetherington, Erin, Tomfohr-Madsen, Lianne, Nettel-Aguirre, Alberto, Chaput, Kathleen H., Tough, Suzanne C.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8635344/
https://www.ncbi.nlm.nih.gov/pubmed/34852012
http://dx.doi.org/10.1371/journal.pone.0260590
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author Scime, Natalie V.
Hetherington, Erin
Tomfohr-Madsen, Lianne
Nettel-Aguirre, Alberto
Chaput, Kathleen H.
Tough, Suzanne C.
author_facet Scime, Natalie V.
Hetherington, Erin
Tomfohr-Madsen, Lianne
Nettel-Aguirre, Alberto
Chaput, Kathleen H.
Tough, Suzanne C.
author_sort Scime, Natalie V.
collection PubMed
description Hypertensive disorders in pregnancy (HDP) are associated with increased risk of offspring neurodevelopmental disorders, suggesting long-term adverse impacts on fetal brain development. However, the relationship between HDP and deficits in general child development is unclear. Our objective was to assess the association between HDP and motor and cognitive developmental delay in children at 36 months of age. We analyzed data from the All Our Families community-based cohort study (n = 1554). Diagnosis of HDP–gestational or chronic hypertension, preeclampsia, or eclampsia–was measured through medical records. Child development was measured by maternal-report on five domains of the Ages and Stages Questionnaire (ASQ-3). Standardized cut-off scores were used to operationalize binary variables for any delay, motor delay, and cognitive delay. We calculated adjusted risk ratios (aRRs) and 95% confidence intervals (CIs) using logistic regression, sequentially controlling for potential confounders followed by factors suspected to lie on the causal pathway. Overall, 8.0% of women had HDP and hypertension-exposed children had higher prevalence of delay than unexposed children. Hypertension-exposed children had elevated risk for developmental delay, but CIs crossed the null. The aRRs quantifying the fully adjusted effect of HDP on child development were 1.19 (95% CI 0.92, 1.53) for any delay, 1.18 (95% CI 0.86, 1.61) for motor delay, and 1.24 (95% CI 0.83, 1.85) for cognitive delay. We did not find a statistically significant association between HDP and developmental delay. Confidence intervals suggest that children exposed to HDP in utero have either similar or slightly elevated risk of any, motor, and cognitive delay at 36 months after controlling for maternal and obstetric characteristics. The observed direction of association aligns with evidence of biological mechanisms whereby hypertensive pathology can disrupt fetal neurodevelopment; however, more evidence is needed. Findings may have implications for early developmental monitoring and intervention following prenatal hypertension exposure.
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spelling pubmed-86353442021-12-02 Hypertensive disorders in pregnancy and child development at 36 months in the All Our Families prospective cohort study Scime, Natalie V. Hetherington, Erin Tomfohr-Madsen, Lianne Nettel-Aguirre, Alberto Chaput, Kathleen H. Tough, Suzanne C. PLoS One Research Article Hypertensive disorders in pregnancy (HDP) are associated with increased risk of offspring neurodevelopmental disorders, suggesting long-term adverse impacts on fetal brain development. However, the relationship between HDP and deficits in general child development is unclear. Our objective was to assess the association between HDP and motor and cognitive developmental delay in children at 36 months of age. We analyzed data from the All Our Families community-based cohort study (n = 1554). Diagnosis of HDP–gestational or chronic hypertension, preeclampsia, or eclampsia–was measured through medical records. Child development was measured by maternal-report on five domains of the Ages and Stages Questionnaire (ASQ-3). Standardized cut-off scores were used to operationalize binary variables for any delay, motor delay, and cognitive delay. We calculated adjusted risk ratios (aRRs) and 95% confidence intervals (CIs) using logistic regression, sequentially controlling for potential confounders followed by factors suspected to lie on the causal pathway. Overall, 8.0% of women had HDP and hypertension-exposed children had higher prevalence of delay than unexposed children. Hypertension-exposed children had elevated risk for developmental delay, but CIs crossed the null. The aRRs quantifying the fully adjusted effect of HDP on child development were 1.19 (95% CI 0.92, 1.53) for any delay, 1.18 (95% CI 0.86, 1.61) for motor delay, and 1.24 (95% CI 0.83, 1.85) for cognitive delay. We did not find a statistically significant association between HDP and developmental delay. Confidence intervals suggest that children exposed to HDP in utero have either similar or slightly elevated risk of any, motor, and cognitive delay at 36 months after controlling for maternal and obstetric characteristics. The observed direction of association aligns with evidence of biological mechanisms whereby hypertensive pathology can disrupt fetal neurodevelopment; however, more evidence is needed. Findings may have implications for early developmental monitoring and intervention following prenatal hypertension exposure. Public Library of Science 2021-12-01 /pmc/articles/PMC8635344/ /pubmed/34852012 http://dx.doi.org/10.1371/journal.pone.0260590 Text en © 2021 Scime et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Scime, Natalie V.
Hetherington, Erin
Tomfohr-Madsen, Lianne
Nettel-Aguirre, Alberto
Chaput, Kathleen H.
Tough, Suzanne C.
Hypertensive disorders in pregnancy and child development at 36 months in the All Our Families prospective cohort study
title Hypertensive disorders in pregnancy and child development at 36 months in the All Our Families prospective cohort study
title_full Hypertensive disorders in pregnancy and child development at 36 months in the All Our Families prospective cohort study
title_fullStr Hypertensive disorders in pregnancy and child development at 36 months in the All Our Families prospective cohort study
title_full_unstemmed Hypertensive disorders in pregnancy and child development at 36 months in the All Our Families prospective cohort study
title_short Hypertensive disorders in pregnancy and child development at 36 months in the All Our Families prospective cohort study
title_sort hypertensive disorders in pregnancy and child development at 36 months in the all our families prospective cohort study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8635344/
https://www.ncbi.nlm.nih.gov/pubmed/34852012
http://dx.doi.org/10.1371/journal.pone.0260590
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