Maternal Hypertensive Pregnancy Disorders and Mental and Behavioral Disorders in the Offspring: a Review

Robinson, Rachel; Lähdepuro, Anna; Tuovinen, Soile; Girchenko, Polina; Rantalainen, Ville; Heinonen, Kati; Lahti, Jari; Räikkönen, Katri; Lahti‐Pulkkinen, Marius

doi:10.1007/s11906-021-01141-w

Cited by 9 publications

(7 citation statements)

References 65 publications

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“…[9][10][11][12][13][14] Finally, both GD and GHT have been associated with attention-deficit/hyperactivity disorder and autism in offspring. 3,4,15 Although rates of GD and PE have not been shown to differ by fetal sex, previous literature supports a sex-specific differential response to these conditions. For example, one study 16 found that male but not female offspring born to women with GD were at greater risk of child overweight or obesity at ages 5 to 7 years.…”

Section: Introductionmentioning

confidence: 92%

“… 9 , 10 , 11 , 12 , 13 , 14 Finally, both GD and GHT have been associated with attention-deficit/hyperactivity disorder and autism in offspring. 3 , 4 , 15 …”

Section: Introductionmentioning

confidence: 99%

“…GHT and PE are associated with an increased risk of peripartum maternal organ failure and mortality, fetal growth restriction and its correlates (eg, neonatal hypoglycemia), and future cardiometabolic disease in both the mother and the offspring . Finally, both GD and GHT have been associated with attention-deficit/hyperactivity disorder and autism in offspring …”

Section: Introductionmentioning

confidence: 99%

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Analysis of Pregnancy Complications and Epigenetic Gestational Age of Newborns

et al. 2023

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ImportancePreeclampsia, gestational hypertension, and gestational diabetes, the most common pregnancy complications, are associated with substantial morbidity and mortality in mothers and children. Little is known about the biological processes that link the occurrence of these pregnancy complications with adverse child outcomes; altered biological aging of the growing fetus up to birth is one molecular pathway of increasing interest.ObjectiveTo evaluate whether exposure to each of these 3 pregnancy complications (gestational diabetes, gestational hypertension, and preeclampsia) is associated with accelerated or decelerated gestational biological age in children at birth.Design, Setting, and ParticipantsChildren included in these analyses were born between 1998 and 2018 and spanned multiple geographic areas of the US. Pregnancy complication information was obtained from maternal self-report and/or medical record data. DNA methylation measures were obtained from blood biospecimens collected from offspring at birth. The study used data from the national Environmental Influences on Child Health Outcomes (ECHO) multisite cohort study collected and recorded as of the August 31, 2021, data lock date. Data analysis was performed from September 2021 to December 2022.ExposuresThree pregnancy conditions were examined: gestational hypertension, preeclampsia, and gestational diabetes.Main Outcomes and MeasuresAccelerated or decelerated biological gestational age at birth, estimated using existing epigenetic gestational age clock algorithms.ResultsA total of 1801 child participants (880 male [48.9%]; median [range] chronological gestational age at birth, 39 [30-43] weeks) from 12 ECHO cohorts met the analytic inclusion criteria. Reported races included Asian (49 participants [2.7%]), Black (390 participants [21.7%]), White (1026 participants [57.0%]), and other races (92 participants [5.1%]) (ie, American Indian or Alaska Native, Native Hawaiian or other Pacific Islander, multiple races, and other race not specified). In total, 524 participants (29.0%) reported Hispanic ethnicity. Maternal ages ranged from 16 to 45 years of age with a median of 29 in the analytic sample. A range of maternal education levels, from less than high school (260 participants [14.4%]) to Bachelor’s degree and above (629 participants [34.9%]), were reported. In adjusted regression models, prenatal exposure to maternal gestational diabetes (β, −0.423; 95% CI, −0.709 to −0.138) and preeclampsia (β, −0.513; 95% CI, −0.857 to −0.170), but not gestational hypertension (β, 0.003; 95% CI, −0.338 to 0.344), were associated with decelerated epigenetic aging among exposed neonates vs those who were unexposed. Modification of these associations, by sex, was observed with exposure to preeclampsia (β, −0.700; 95% CI, −1.189 to −0.210) and gestational diabetes (β, −0.636; 95% CI, −1.070 to −0.200), with associations observed among female but not male participants.Conclusions and RelevanceThis US cohort study of neonate biological changes related to exposure to maternal pregnancy conditions found evidence that preeclampsia and gestational diabetes delay biological maturity, especially in female offspring.

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Section: Introductionmentioning

confidence: 92%

“… 9 , 10 , 11 , 12 , 13 , 14 Finally, both GD and GHT have been associated with attention-deficit/hyperactivity disorder and autism in offspring. 3 , 4 , 15 …”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Analysis of Pregnancy Complications and Epigenetic Gestational Age of Newborns

et al. 2023

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“…demonstrating that offspring exposure to HDP in utero is associated with metabolic syndrome, 6 mental and behavioral disorders, 7 asthma, 8 and other conditions. Several reviews have shown that offspring born to mothers with HDP have higher blood pressure (BP).…”

Section: Introductionmentioning

confidence: 97%

“…HDP are divided into hypertension known before pregnancy or present in the first 20 weeks, including chronic hypertension, white‐coat hypertension, and masked hypertension, and hypertension arising de novo at or after 20 weeks, including gestational hypertension (GH), preeclampsia (PE) de novo or superimposed on chronic hypertension, and transient GH 5 . Previous studies have confirmed that women who develop HDP have an increased risk of cardiovascular disease later in life, while there have been studies demonstrating that offspring exposure to HDP in utero is associated with metabolic syndrome, 6 mental and behavioral disorders, 7 asthma, 8 and other conditions. Several reviews have shown that offspring born to mothers with HDP have higher blood pressure (BP) 9 .…”

Section: Introductionmentioning

confidence: 99%

Association between hypertensive disorders during pregnancy and elevated blood pressure in offspring: A systematic review and meta‐analysis

Mao

et al. 2022

J of Clinical Hypertension

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Hypertensive disorders during pregnancy (HDP) are associated with cardiovascular disease among mothers and offspring. This meta-analysis was conducted to further explore the associations between maternal HDP and offspring blood pressure (BP). The authors performed a search strategy in PubMed, Embase, Web of Science, and Cochrane library from database inception to January 2022. Twenty-four studies regarding HDP were included, with pregnancy-associated hypertension (PAH), preeclampsia (PE), gestational hypertension (GH), and chronic hypertension included in 12, 16, 6, and 3 studies, respectively. Offspring who were exposed to HDP and PAH

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Pregnancy complications and childhood mental health: is the association modified by sex or adverse social circumstances? Findings from the ‘growing up in Ireland’ national infant cohort study

Butler,

Clarke,

Spirtos

et al. 2024

Soc Psychiatry Psychiatr Epidemiol

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Specific pregnancy complications, socioeconomic position and sex have all been independently associated with child mental health outcomes, but their combined effects remain unclear. We examined whether total number of complications experienced in the pregnancy associated with mental health at 5 and 9-years, and whether this varied by sex or adverse social circumstances. Pregnancy complications were self-reported at 9-months post-natally from a list of 16 complications. Parents completed the Strengths and Difficulties Questionnaire (SDQ) when their child was 5 and 9-years. The primary outcome was the SDQ-total and scoring in the clinical range (> 16) was a secondary outcome. We applied generalized linear mixed models to a large nationally representative Irish cohort (GUI; n = 11,134). Analyses were adjusted for sex, adverse social circumstances (at 9-months), and gestational smoking. We included an interaction term between pregnancy complications and each variable respectively in separate models to examine if associations varied by sex or adverse circumstances.After controlling for covariates, total complications associated with mental health at 5 and 9-years. Each additional pregnancy complication conferred a 10% higher total-SDQ score (exponentiated co-efficient 1.10 [95%CI 1.06–1.14], 1.20 [1.15–1.26], 1.20 [1.12–1.29] and 1.34 [1.21–1.48] for 1, 2, 3 and 4 + complications respectively). For the dichotomised outcome, generally increasing odds for clinical levels of mental health difficulties were observed (OR 1complication = 1.89, 95%CI [1.37–2.59]; OR 2complications = 2.31, 95%CI [1.53–3.50]; OR 3complications = 1.77, 95%CI [0.89–3.52]; OR 4 + complications = 6.88, 95%CI [3.29–14.40]). Females had significantly lower odds of exhibiting clinically significant mental health difficulties than males (OR = 0.43, 95%CI[0.32–0.57]).There was no evidence that the association between pregnancy complications and child’s mental health varied by sex or social circumstances at 5 or 9-years. Males exposed to numerous pregnancy complications in the context of adverse social circumstances had the highest predicted probability of having mental health difficulties in middle childhood.

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Maternal Hypertensive Pregnancy Disorders and Mental and Behavioral Disorders in the Offspring: a Review

Cited by 9 publications

References 65 publications

Analysis of Pregnancy Complications and Epigenetic Gestational Age of Newborns

Analysis of Pregnancy Complications and Epigenetic Gestational Age of Newborns

Association between hypertensive disorders during pregnancy and elevated blood pressure in offspring: A systematic review and meta‐analysis

Pregnancy complications and childhood mental health: is the association modified by sex or adverse social circumstances? Findings from the ‘growing up in Ireland’ national infant cohort study

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