scholarly journals Association between hypertensive disorders of pregnancy and cardiovascular disease in a population of Cameroonian women at two hospitals of yaounde : a case control study

2018 ◽  
Author(s):  
Benedict Taa Nguimbis Esseme ◽  
Mbondji Ebongué
Keyword(s):  
Cardiovascular Disease ◽  
Cardiovascular Diseases ◽  
Gestational Hypertension ◽  
Case Control ◽  
Sub Saharan Africa ◽  
Pediatric Care ◽  
Hypertensive Disorders Of Pregnancy ◽  
Hypertensive Disorders ◽  
Increased Risk ◽  
History Of

AbstractBackground: Positive associations have been found between Hypertensive Disorders of Pregnancy gestational hypertension, preeclampsia and cardiovascular diseases within non-black African populations, but no data exist from sub-Saharan Africa. We aimed to assess this association in Cameroonian mothers.Methods: We used a case-control design. Cases were women diagnosed with arteriosclerotic cardiovascular disease between 2012 and 2017 at the General and the Gyneco-obstetric hospital of Yaoundé. Controls were mothers of children who seeked pediatric care at the Gyneco-obstetric hospital of Yaoundé, with no diagnosis of cardiovascular disease. We abstracted data from patient files to assess cardiovascular disease, and used phone-based questionnaires to assess prior history of Hypertensive Disorders of Pregnancy. We used logistic regression and propensity scores for adjustment. Results: Out of 1228 individuals selected, 173 cases and 339 controls participated in the study. We found no increased risk of cardiovascular diseases for women with a history of Hypertensive Disorders of Pregnancy (OR = 0.83, 95% CI, 0.51 to 1.34). Women with gestational hypertension had 2.33 (95% CI, 0.99 to 5.50) times the risk of women with no history of Hypertensive Disorders of Pregnancy, an inverse association was observed between preeclampsia and cardiovascular diseases (OR = 0.28, 95% CI, 0.10 to 0.72). Conclusions: Cameroonian women with a history of gestational hypertension may have an increased risk of cardiovascular diseases. However, population-based studies with more accurate data on the exposure are needed.

scholarly journals Assessing knowledge of healthcare providers concerning cardiovascular risk after hypertensive disorders of pregnancy: an Australian national survey

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Heike Roth ◽  
Caroline S. E. Homer ◽  
Clare Arnott ◽  
Lynne Roberts ◽  
Mark Brown ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Cardiovascular Risk ◽  
Cardiovascular Health ◽  
Gestational Hypertension ◽  
Current Knowledge ◽  
Healthcare Providers ◽  
Hypertensive Disorders Of Pregnancy ◽  
Hypertensive Disorders ◽  
Increased Risk

Abstract Background Hypertensive disorders of pregnancy (HDP) affect 5–10% of pregnant women. Women after HDP have 2–3 times increased risk of heart attack, stroke and diabetes, as soon as 5–10 years after pregnancy. Australian healthcare providers’ knowledge of cardiovascular disease (CVD) risks for women after HDP is unknown, and this study aimed to explore their current knowledge and practice regarding long-term cardiovascular health after HDP, as a precursor to producing targeted healthcare provider education on health after HDP. Methods A custom-created, face-validated online survey explored knowledge about long-term risks after HDP. Distribution occurred from February to July 2019 via professional colleges, key organisations and social media. The objective was to assess current knowledge and knowledge gaps amongst a group of healthcare providers (HCP) in Australia, regarding long-term cardiovascular health after hypertensive disorders of pregnancy (HDP), specifically gestational hypertension or preeclampsia. Results Of 492 respondents, 203 were midwives, 188 obstetricians, 75 general practitioners (GP), and 26 cardiologists. A risk knowledge score was computed with 0–6 considered low, 6.1–8.9 moderate and 9–12 high. Most participants (85%) were aware of increased cardiovascular disease after preeclampsia and gestational hypertension (range 76% midwives to 100% cardiologists). There were significant differences in average knowledge scores regarding health after preeclampsia; high for cardiologists (9.3), moderate for GPs and obstetricians (8.2 and 7.6 respectively) and low for midwives (5.9). Average knowledge scores were somewhat lower for gestational hypertension (9.0 for cardiologists, 7.4 for obstetricians and GPs, 5.1 for midwives). Knowledge was highest regarding risk of chronic hypertension, moderate to high regarding risk of ischaemic heart disease, stroke and recurring HDP, and low for diabetes and peripheral vascular disease. Only 34% were aware that risks start < 10 years after the affected pregnancy. Conclusion(s) Participants were aware there is increased cardiovascular risk after HDP, although less aware of risks after gestational hypertension and some specific risks including diabetes. Findings will inform the development of targeted education.

scholarly journals Hypertensive Disorders of Pregnancy and Risk of Cardiovascular Disease-Related Morbidity and Mortality: A Systematic Review and Meta-Analysis

Cardiology ◽  
2020 ◽  
Vol 145 (10) ◽  
pp. 633-647
Author(s):  
Rong Wu ◽  
Tingting Wang ◽  
Runhui Gu ◽  
Dexiu Xing ◽  
Changxiang Ye ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Reference Group ◽  
Morbidity And Mortality ◽  
Significant Heterogeneity ◽  
Hypertensive Disorders Of Pregnancy ◽  
Case Control Studies ◽  
Hypertensive Disorders ◽  
Increased Risk ◽  
History Of ◽  
Related Mortality

Introduction: Several studies have demonstrated that there is a higher risk of cardiovascular disease (CVD) in women with a history of hypertensive disorders of pregnancy (HDP). However, effect sizes varied greatly between these studies, and a complete overview of the existing data in the literature is lacking. We aimed to evaluate the association between HDP and the risk of CVD-related morbidity and mortality. Methods: Systematic literature searches were conducted in several electronic databases from inception to July 2019. Exposure of interest was any type of HDP. Outcomes of interest included any CVD, CVD-related mortality, and hypertension. Results: Sixty-six cohort and 7 case-control studies involving >13 million women were included. The overall combined relative risks (RRs) for women with a history of HDP compared with the reference group were 1.80 (95% confidence interval [CI] 1.67–1.94) for any CVD, 1.66 (1.49–1.84) for coronary artery heart disease, 2.87 (2.14–3.85) for heart failure, 1.60 (1.29–2.00) for peripheral vascular disease, 1.72 (1.50–1.97) for stroke, 1.78 (1.58–2.00) for CVD-related mortality, and 3.16 (2.74–3.64) for hypertension. Significant heterogeneity was partially explained by all or part of the variables including type of exposure, follow-up time, geographic region, and sample source. Conclusions: Women with a history of HDP are at an increased risk of future CVD-related morbidity and mortality. Our study highlights the importance of life-long monitoring of cardiovascular risk factors in women with a history of HDP.

scholarly journals Patterns of Postpartum Ambulatory Care Follow‐up Care Among Women With Hypertensive Disorders of Pregnancy

2020 ◽  
Vol 9 (17) ◽  
Author(s):  
Jennifer Lewey ◽  
Lisa D. Levine ◽  
Lin Yang ◽  
Jourdan E. Triebwasser ◽  
Peter W. Groeneveld
Keyword(s):  
Cardiovascular Disease ◽  
Primary Care ◽  
Cardiovascular Risk ◽  
Gestational Hypertension ◽  
Multivariable Analysis ◽  
Chronic Hypertension ◽  
Hypertensive Disorders Of Pregnancy ◽  
Hypertensive Disorders ◽  
Increased Risk

Background Preeclampsia and gestational hypertension are hypertensive disorders of pregnancy (HDP) that identify an increased risk of developing chronic hypertension and cardiovascular disease later in life. Postpartum follow‐up may facilitate early screening and treatment of cardiovascular risk factors. Our objective is to describe patterns of postpartum visits with primary care and women's health providers (eg, family medicine and obstetrics) among women with and without HDP in a nationally representative sample of commercially insured women. Methods and Results We conducted a retrospective cohort study using insurance claims from a US health insurance database to describe patterns in office visits in the 6 months after delivery. We identified 566 059 women with completed pregnancies between 2005 and 2014. At 6 months, 13% of women with normotensive pregnancies, 18% with HDP, and 23% with chronic hypertension had primary care visits ( P <0.0001 for comparing HDP and chronic hypertension groups with control participants). Only 58% of women with HDP had 6‐month follow‐up with any continuity provider compared with 47% of women without hypertension ( P <0.0001). In multivariable analysis, women with severe preeclampsia were 16% more likely to have postpartum continuity follow‐up (adjusted odds ratio, 1.16; 95% CI, 1.2–1.21). Factors associated with a lower likelihood of any follow‐up included age ≥30 years, Black race, Hispanic ethnicity, and having multiple gestations. Conclusions Rates of continuity care follow‐up after a pregnancy complicated by hypertension were low. This represents a substantial missed opportunity to provide cardiovascular risk screening and management to women at increased risk of future cardiovascular disease.

scholarly journals Hypertensive disorders of pregnancy and risk of Alzheimer’s disease, vascular dementia, and other related dementia

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 653-653
Author(s):  
Karen Schliep ◽  
Yue Zhang ◽  
Joanne Tschanz ◽  
Jennifer Majersik ◽  
Julio Facelli ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Vascular Dementia ◽  
Gestational Hypertension ◽  
Hypertensive Disorders Of Pregnancy ◽  
Population Database ◽  
Hypertensive Disorders ◽  
Increased Risk ◽  
History Of ◽  
Dementia Subtype

Abstract Several recent studies have examined whether hypertensive disorders of pregnancy (HDP) are associated with an increased risk for Alzheimer’s disease (AD) and other related dementias (RD) with conflicting findings. Limitations to prior studies include lack of assessing risk by dementia subtype, inadequate sample sizes, and not fully exploring the role of mid-life factors. We performed a retrospective matched cohort study among women with &gt;1 singleton pregnancy (1939–2013) using the Utah Population Database. HDP-exposed women (n=19,989) were one-to-two matched with unexposed women (n=39,679) by 5-year age groups, year of childbirth (within 1 year), and parity (1, 2, 3, 4, ≥5) at the time of the pregnancy. HDP pregnancies were complicated by preeclampsia (62%), gestational hypertension (34%), and eclampsia (4%). Women with a history of HDP had a higher hazard of all-cause dementia (HR=1.37; 95% CI: 1.26, 1.50) compared to women without a history of HDP after adjustment for maternal age, year of childbirth, and parity. The hazard doubled after additionally accounting for pre-pregnancy BMI (HR=2.31; 95% CI: 1.24, 4.32). Stratifying by dementia subtype, we found HDP to be associated with a higher hazard of vascular dementia (HR=1.64; 95% CI: 1.19, 2.26) and other related dementia (HR=1.49; 95% CI: 1.34, 1.65) but not Alzheimer’s disease (HR=1.04; 95% CI: 0.87, 1.24) after accounting for competing risks. Mid-life hypertension and stroke were found to have the greatest mid-life impact, mediating 43% and 41% of dementia risk, respectively, highlighting women who may most benefit from close surveillance and early preventive and clinical interventions.

Basal Plate Myometrial Fibers and Hypertensive Disorders of Pregnancy: A Case–Control Study

2017 ◽  
Vol 21 (3) ◽  
pp. 296-299 ◽  
Author(s):  
Ann A Wang ◽  
Linda M Ernst ◽  
Emily S Miller
Keyword(s):  
Case Control Study ◽  
Gestational Hypertension ◽  
Case Control ◽  
Basal Plate ◽  
Common Finding ◽  
Pathological Examination ◽  
Chronic Hypertension ◽  
Hypertensive Disorders Of Pregnancy ◽  
Hypertensive Disorders ◽  
Control Study

Introduction Basal plate myometrium (BPMYO), the pathological presence of myometrial fibers in the basal plate, is a common finding on pathological examination of the placenta, yet its clinical correlates are not well studied. As myometrial fibers are frequently located in proximity to poorly converted maternal spiral arteries, our objective was to determine whether BPMYO is associated with hypertensive disorders of pregnancy (HDP), a well-known clinical sequela of abnormal maternal artery remodeling. Methods This case–control study included women who delivered a live-born singleton gestation whose placentas were sent for pathological examination. Cases were women with HDP (gestational hypertension, preeclampsia, or HELLP syndrome) as defined by American College of Obstetricians and Gynecologists. Controls were women without HDP. Women with chronic hypertension were excluded. The primary outcome was the presence of BPMYO. Secondary outcomes included the pathologic stage of BPMYO and the incidence of pathologically defined accreta. Each outcome was compared between cases and controls in bivariable and multivariable analyses. Results Of the 306 women who met inclusion criteria, 230 (75%) had HDP. BPMYO was present in 99 (32%) of placentas. Compared to controls, cases were younger, had higher body mass index, and were more likely to have diabetes, be nulliparous, deliver preterm, and have had a prior cesarean. There were no differences in the incidence of BPMYO, stage of BPMYO, or incidence of pathologically defined accreta between cases and controls. These findings persisted after controlling for potential confounders. Conclusions Although BPMYO may be more common in the setting of abnormal placental vasculature, there is no significant association between BPMYO and HDP.

scholarly journals Can serum homocysteine predict hypertensive disorders of pregnancy?: an evidence from a case control study in a North Indian tertiary health care institution

2019 ◽  
Vol 8 (8) ◽  
pp. 3117
Author(s):  
Kushla Pathania ◽  
S. K. Verma ◽  
Shaina Chamotra ◽  
Ankit Chaudhary
Keyword(s):  
Case Control Study ◽  
Homocysteine Level ◽  
Perinatal Outcomes ◽  
Case Control ◽  
Unknown Etiology ◽  
Intrauterine Death ◽  
Hypertensive Disorders Of Pregnancy ◽  
Hypertensive Disorders ◽  
Increased Risk ◽  
Control Study

Background: Hypertensive disorders of pregnancy are a major cause of both maternal and foetal morbidity and mortality. Although pregnancy induced hypertension (PIH) is still regarded as a disease of theories and unknown etiology, elevated homocysteine level has been hypothesized as a key risk factor. Abnormally raised homocysteine has been significantly associated with increased risk of PIH, abruption, intrauterine growth restriction, recurrent pregnancy loss, intrauterine death and prematurity.Methods: The present case control study was conducted among 180 pregnant women (90 cases and 90 controls) in Kamla Nehru State Hospital for Mother and Child, IGMC Shimla, Himachal Pradesh with an objective of ascertaining the role of homocysteine in pregnancy related hypertensive disorders. Socio-demographic, clinical, biochemical including homocysteine level, laboratory and ultrasonographic parameters of all the participants were documented.Results: The mean homocysteine level of cases (18.30±10.81) was significantly higher than the controls (8.70±2.64).  About 62.2% cases had abnormally raised homocysteine level (>15 µmol/L), while only 1.1% controls had such level. The odds of a case having abnormally elevated homocysteine level were 146.6 (CI: 19.52-1101) times to that of controls. Eclamptics had the highest homocysteine level followed by preeclamptics and controls.Conclusions: The present study significantly associates the abnormally elevated homocysteine levels with pregnancy related hypertensive ailments and demands much needed robustly designed studies to further explore the phenomenon. A simple intervention like estimating the much neglected homocysteine levels prior to pregnancy can definitely aid in predicting and preventing perinatal outcomes.

scholarly journals Prepregnancy adherence to dietary recommendations for the prevention of cardiovascular disease in relation to risk of hypertensive disorders of pregnancy

2020 ◽  
Vol 112 (6) ◽  
pp. 1429-1437 ◽  
Author(s):  
Mariel Arvizu ◽  
Jennifer J Stuart ◽  
Janet W Rich-Edwards ◽  
Audrey J Gaskins ◽  
Bernard Rosner ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
General Population ◽  
Gestational Hypertension ◽  
Health Study ◽  
Hypertensive Disorders Of Pregnancy ◽  
Dietary Recommendations ◽  
Cvd Risk ◽  
Adherence To Diet ◽  
Hypertensive Disorders ◽  
Prevention Of Cardiovascular Disease

ABSTRACT Background It is unclear whether adherence to diet recommendations for the prevention of cardiovascular disease (CVD) in the general population is also related to the risk of hypertensive disorders of pregnancy, including pre-eclampsia and gestational hypertension (GHTN). Objectives The aim was to evaluate the relation of prepregnancy adherence to the American Heart Association (AHA) diet recommendations and the Dietary Approaches to Stop Hypertension (DASH) with the risk of pre-eclampsia and GHTN. Methods Between 1991 and 2009, we prospectively followed 16,892 singleton pregnancies among 11,535 women who participated in the Nurses’ Health Study II. Prepregnancy diet was assessed every 4 y, from which we calculated dietary pattern scores from the DASH diet (8 components) and the diet recommendations from the AHA 2020 Strategic Impact Goals (primary score: 5 components; secondary score: primary score plus 3 components). Pregnancy outcomes were self-reported, and we estimated the RR (95% CI) of pre-eclampsia and GHTN with log-binomial regression using generalized estimating equations to account for repeat pregnancies and adjusting for potential confounders. Results Women had a mean (SD) age of 34.4 (34.0) y at pregnancy. Pre-eclampsia was reported in 495 (2.9%) pregnancies and GHTN in 561 (3.3%) pregnancies. The RR (95% CI) of pre-eclampsia for women in the highest quintile of the DASH was 0.65 (0.48, 0.87) compared with women in the lowest score quintile. A similar inverse trend was observed for the AHA primary (0.74; 95% CI: 0.55, 1.00) and secondary (0.81; 95% CI: 0.61, 1.07) scores comparing women in the highest versus the lowest score quintile. Neither the DASH nor the AHA scores were related to GHTN. Conclusions Women with higher adherence to dietary recommendations for the prevention of CVD in the general population had a lower risk of pre-eclampsia—a common pregnancy complication related to higher CVD risk among women—than women with lower adherence to these recommendations.

Abstract MP63: Established Cardiovascular Disease Risk Factors Mediate The Relationship Between Hypertensive Disorders In First Pregnancy And Maternal Cardiovascular Disease

Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Jennifer J Stuart ◽  
Lauren J Tanz ◽  
Eric B Rimm ◽  
Donna Spiegelman ◽  
Stacey A Missmer ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Chronic Hypertension ◽  
Cvd Risk Factors ◽  
First Birth ◽  
Cvd Risk ◽  
Hypertensive Disorders ◽  
Increased Risk ◽  
History Of ◽  
The Relationship

Introduction: Women with a history of hypertensive disorders in pregnancy (HDP; gestational hypertension [GHTN] or preeclampsia) have an increased risk of CVD risk factors and events compared to women with normotensive pregnancies. However, the extent to which the relationship between HDP and CVD events is mediated by established CVD risk factors is less clear. Hypothesis: We hypothesized that a large proportion of the HDP-CVD relationship would be mediated by subsequent CVD risk factors — chronic hypertension (CHTN), type 2 diabetes (T2D), hypercholesterolemia, and BMI. Methods: Parous women free of prior CVD events, CHTN, T2D, and hypercholesterolemia at first birth in the Nurses’ Health Study II comprised the analytic sample (n=57,974). Pregnancy history was retrospectively reported in 2009. Women were followed for confirmed CVD events (coronary heart disease [non-fatal or fatal MI, fatal CHD] or stroke [non-fatal or fatal]) from first birth through 2015. Potential mediators were self-reported on biennial questionnaires. We used Cox proportional hazards models to estimate hazard ratios (HR) and 95% confidence intervals (CI) for the relationship between HDP in first pregnancy (preeclampsia or GHTN vs. normotension [ref]) and CVD, adjusting for age, race/ethnicity, parental education, family history of CVD before age 60, and pre-pregnancy risk factors (e.g., smoking, diet, and BMI). To evaluate the proportion of the HDP-CVD association that was jointly mediated by the CVD risk factors we used the difference method, comparing a model including these four factors to a model without them. Results: Nine percent of women (n=5,306) had a history of HDP in first pregnancy (preeclampsia: 6.3%; GHTN: 2.9%). CVD events occurred in 650 women with normotension in first pregnancy, 30 with GHTN, and 81 with preeclampsia. Adjusting for pre-pregnancy confounders, women with HDP in first pregnancy had a 63% higher rate of incident CVD (CI: 1.33-2.00) compared to women with normotension in first pregnancy; in particular, the strongest association was observed between preeclampsia and CHD (HR=2.18, CI: 1.62-2.93). The overall HDP-CVD association was largely mediated by the group of four CVD risk factors (HDP: proportion mediation [PM]=65%, CI: 35-87; preeclampsia: PM=57%, CI: 21-87; GHTN: PM=99%, CI: inestimable). All CVD risk factors contributed to mediation, but chronic hypertension accounted for the largest proportion. Conclusions: While approximately 40% of the association between preeclampsia and CVD remained unexplained, almost all the increased risk of CVD conferred by a history of GHTN was jointly accounted for by the development of established risk factors postpartum. Screening for CHTN, T2D, hypercholesterolemia, and overweight/obesity after pregnancy may be especially helpful in CVD prevention among women with a history of HDP.

scholarly journals Risk factors associated with hypertensive disorders in pregnancy in Nekemte referral hospital, from July 2015 to June 2017, Ethiopia: case-control study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Leta Hinkosa ◽  
Almaz Tamene ◽  
Negeso Gebeyehu
Keyword(s):  
Risk Factors ◽  
Case Control Study ◽  
Case Control ◽  
Hypertensive Disorders Of Pregnancy ◽  
Positive History ◽  
Factors Associated ◽  
Hypertensive Disorders ◽  
History Of ◽  
Control Study ◽  
In Pregnancy

Abstract Background Hypertension is the most common medical problem encountered in pregnancy and is a leading cause of perinatal and maternal morbidity and mortality. However, its magnitude and risk factors yet not adequately assessed at the study area. Methods Facility-based retrospective unmatched case-control study was conducted to identify risk factors associated with Hypertensive disorders of pregnancy in Nekemte Referral Hospital just two years back from study period July 1, 2015, to June 30, 2017. Bivariate logistic regression was considered for inclusion in to the multivariate logistic regression. Finally, multi varaite analysis were done to identify risk factors of hypertensive disorders of pregnancy. Results Among 6826 total delivery records from July 2015 –June 2017, 199 women developed hypertension during pregnancy. Among 199 women 153(76.9%) were pre-eclampsia/eclampsia,28(14.1%) were gestational hypertension, 14(0.7%) were superimposed hypertension and 4 (2.9%) were chronic hypertension. Age ≥ 35 (AOR: 2.51, 95% CI: 1.08, 5.83), rural residential area (AOR: 1.79, 95% CI: 1.150, 2.799), prim gravida (AOR: 3.39, 95% CI: 2.16, 5.33), null parity (AOR: 4.35, 95% CI: 2.36, 8.03), positive history of abortion (AOR: 4.39, 95% CI: 1.64, 11.76), twin pregnancy (AOR: 3.78, 95% CI: 1.52, 9.39), lack of ANC follow up (AOR: 3.05, 95% CI: 1.56, 5.96) as well as positive pre-existing hypertension (AOR: 3.81, 95% CI: 1.69, 8.58), positive family history of hypertension (AOR: 5.04, 95% CI: 2.66, 9.56) and positive history of diabetes mellitus (AOR: 5.03, 95% CI: 1.59, 15.89) were risk factors for hypertensive disorders during pregnancy. Conclusion This study found that Women with hypertension during pregnancy have a greater risk of developing adverse pregnancy outcome as compared to normotensive pregnant women. so, identification of these risk factors would be useful for early diagnosis of hypertension disorders during pregnancy to give appropriate clinical monitoring and treatments and timely managing maternal and perinatal complications.

Association between maternal hypertensive disorders of pregnancy and child neurodevelopment at 3 years of age: a retrospective cohort study

2020 ◽  
pp. 1-8 ◽  
Author(s):  
Masahiro Noda ◽  
Satomi Yoshida ◽  
Hiroki Mishina ◽  
Keisuke Matsubayashi ◽  
Koji Kawakami
Keyword(s):  
Confidence Interval ◽  
Gestational Hypertension ◽  
Exposed Group ◽  
Control Group ◽  
Developmental Abnormality ◽  
Hypertensive Disorders Of Pregnancy ◽  
Developmental Abnormalities ◽  
Hypertensive Disorders ◽  
Increased Risk ◽  
Child Neurodevelopment

Abstract Hypertensive disorders of pregnancy (HDP) affect up to 10% of women during pregnancy and influence child neurodevelopment, including mental and motor function. We assessed whether HDP, including gestational hypertension, preeclampsia, superimposed preeclampsia, and eclampsia, correlate with motor and mental developmental abnormalities in 3-year-old children, using data obtained between April 2004 and March 2013 through a mandatory population-based health checkup of mothers and children in Kobe city, Japan. The primary outcome was motor and mental developmental abnormalities at 3 years of age; parental-reported questionnaires and physician’s medical examinations were evaluated. The association between maternal HDP and child neurodevelopmental abnormality was evaluated using a logistic regression model. Of the 43,854 participating children, 1120 were born to women with HDP and 42,734 were born to women without HDP. The prevalence of motor developmental abnormality was 1.7% in the exposed group and 0.95% in the control group; the prevalence of mental developmental abnormality was 2.41% in the exposed group and 1.22% in the control group. Children born to mothers with HDP did not have an increased risk of motor developmental abnormality at the age of 3 years [adjusted odds ratio (OR) 1.17, 95% confidence interval 0.72–1.91], but had an increased risk of mental developmental abnormality (adjusted OR 1.80, 95% confidence interval 1.21–2.69). Maternal HDP were associated with mental development abnormality in 3-year-old children. These findings may be clinically relevant; mental abnormality in children born to women with HDP could be detected during early stages, which would facilitate early intervention.

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