Preeclampsia at term is linked to neurodevelopmental conditions in offspring

  • Sun BZ & al.
  • JAMA Psychiatry
  • 01.04.2020

  • von Susan London
  • Clinical Essentials
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Takeaway

  • Children born at term to mothers with preeclampsia have increased odds for ADHD, autism, epilepsy, and intellectual disability.

Why this matters

  • Few studies have separated preterm from term births in examining these outcomes.
  • The direction of and timing of the association are unknown.

Key results

  • Mothers of 2.9% of the cohort had preeclampsia.
  • With a mean 14.0-year follow-up, relative to unexposed children, exposed children had elevated odds (aORs; 95% CIs) for:
    • ADHD: 1.18 (1.05-1.33).
    • Autism: 1.29 (1.08-1.54).
    • Epilepsy: 1.50 (1.16-1.93).
    • Intellectual disability: 1.50 (1.13-1.97).
  • Odds of cerebral palsy were marginally elevated: aOR, 1.30 (95% CI, 0.94-1.80).
  • Odds of vision/hearing loss were not significantly elevated.
  • Findings were similar, but with stronger associations for cerebral palsy and vision/hearing loss in analyses, including both term and preterm births.

Study design

  • Norwegian prospective, population-based cohort study of 980,560 term singleton infants.
  • Main outcome: neurodevelopmental conditions.
  • Funding: Intramural Research Program of NIH; National Institute of Environmental Health Sciences; Western Norwegian Regional Health Authority.

Limitations

  • Possible ascertainment bias toward cases of more severe exposure, outcomes.
  • Unknown, unmeasured confounding.
  • Lack of information on preeclampsia duration, severity.
  • No causation established, direction or mediators of associations not known.