Citation
Palatnik, Anna; Casey, Brian M.; Varner, Michael W.; Sorokin, Yoram; Reddy, Uma M.; Wapner, Ronald J.; Thorp, John M., Jr.; Saade, George R.; Tita, Alan T. N.; & Rouse, Dwight J., et al. (2022). Association between Hypertensive Disorders of Pregnancy and Long-Term Neurodevelopmental Outcomes in the Offspring. American Journal of Perinatology, 39(9), 921-929. PMCID: PMC9081295Abstract
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: A secondary analysis of two parallel multicenter clinical trials of thyroxine therapy for subclinical hypothyroid disorders in pregnancy. Women with singleton non-anomalous 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 were Bayley-III cognitive, motor and language scores at 12 and 24 months, 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. Associations between neurodevelopment outcomes and maternal HDP were examined using univariable and multivariable analyses.
RESULTS: A total of 112 woman-child dyads with HDP were compared with 1067 woman-child dyads without HDP. In univariable analysis, mean maternal age (26.7±5.9 vs. 27.8±5.7 years, p=0.032) and nulliparity (45.5% vs. 31.0%, p=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 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 two years of age among offspring exposed to HDP compared with those unexposed (46.5% versus 30.5%, adjusted odds ratio 2.22, 95% CI 1.44 - 3.42).
CONCLUSIONS: 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.
URL
http://dx.doi.org/10.1055/a-1692-0659Reference Type
Journal ArticleYear Published
2022Journal Title
American Journal of PerinatologyAuthor(s)
Palatnik, AnnaCasey, Brian M.
Varner, Michael W.
Sorokin, Yoram
Reddy, Uma M.
Wapner, Ronald J.
Thorp, John M., Jr.
Saade, George R.
Tita, Alan T. N.
Rouse, Dwight J.
Sibai, Baha M.
Costantine, Maged M.
Mercer, Brian M.
Tolosa, Jorge E.
Caritis, Steve N.