Association of Preeclampsia and Perinatal Complications With Offspring Neurodevelopmental and Psychiatric Disorders
Maternal preeclampsia has been reported to increase the risk of autism spectrum disorder, attention-deficit/hyperactivity disorder (ADHD), and intellectual disability in offspring. However, the association between maternal preeclampsia combined with perinatal complications and neurodevelopmental and...
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| description | Maternal preeclampsia has been reported to increase the risk of autism spectrum disorder, attention-deficit/hyperactivity disorder (ADHD), and intellectual disability in offspring. However, the association between maternal preeclampsia combined with perinatal complications and neurodevelopmental and psychiatric disorders in offspring is less well documented.
To examine the association of maternal preeclampsia, separately and together with perinatal complications, with neurodevelopmental and psychiatric disorders in offspring.
This population-based cohort study used data from nationwide registries in Finland to assess all singleton live births (N = 1 012 723) between January 1, 1996, and December 31, 2014. Offspring were followed up until December 31, 2018 (when the oldest reached age 22 years). Exclusion criteria were maternal inpatient psychiatric diagnoses and pregestational diabetes. The study and data analysis were conducted from May 1, 2020, to June 1, 2021.
Preeclampsia and perinatal complications (delivery earlier than 34 weeks' gestation and/or small for gestational age).
The primary outcomes were neurodevelopmental and psychiatric diagnoses and dispensation of psychotropic drugs among offspring until December 31, 2018. Cox proportional hazards regression analyses were performed to assess the associations.
Of 1 012 723 singleton live births (51.1% boys; mean [SD] maternal age at birth, 30.0 [5.4] years; specific data on race and ethnicity were not available in the data set), 21 010 children (2.1%) were exposed to preeclampsia alone, 33 625 children (3.3%) were exposed to perinatal complications alone, and 4891 children (0.5%) were exposed to both preeclampsia and perinatal complications. A total of 93 281 children (9.2%) were diagnosed with a neurodevelopmental or psychiatric disorder. Offspring exposed to both preeclampsia and perinatal complications had an increased risk of any neurodevelopmental or psychiatric disorder after adjusting for potential confounding (adjusted hazard ratio [aHR], 2.11; 95% CI, 1.96-2.26) compared with those not exposed to either preeclampsia or perinatal complications; this risk was higher than exposure to either preeclampsia alone (aHR, 1.18; 95% CI, 1.12-1.23) or perinatal complications alone (aHR, 1.77; 95% CI, 1.72-1.82). Sibling pair analyses did not detect any increase in the risk of neurodevelopmental or psychiatric disorders after exposure to preeclampsia alone, but offspring exposed to both preeclampsia and pe |
| doi_str_mv | 10.1001/jamanetworkopen.2021.45719 |
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| fullrecord | <record><control><sourceid>proquest_swepu</sourceid><recordid>TN_cdi_swepub_primary_oai_swepub_ki_se_455903</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2667743666</sourcerecordid><originalsourceid>FETCH-LOGICAL-a561t-92c0ae754da9ff83f0a1b3e1e547bd08bd3954e9eb7047b006d8b55374267a293</originalsourceid><addsrcrecordid>eNp1kstu1TAQhiMEolXpK6AINmxy8P3CAqk6QItU0S5ALC3HmfT4NImDnbTq2-NzaWkrsfLI8_2jufxF8Q6jBUYIf1zb3g4w3YZ4HUYYFgQRvGBcYv2iOCRcsooqxF8-ig-K45TWCCGCMNWCvy4OKEdKU6YPi3SSUnDeTj4MZWjLywjgOtuPydvSDk15CdEPdrJduQz92Hm3RVP520-r8qJt05jzV-UPmGNo4Aa6MPYwbPitOt25Va4evSu_-BRiAzG9KV61tktwvH-Pil_fvv5cnlXnF6fflyfnleUCT5UmDlmQnDVWt62iLbK4poCBM1k3SNUN1ZyBhlqi_IOQaFTNOZWMCGmJpkdFtaubbmGca5M77W28M8F6s_-6zhEYxrlGNPP6v_yYp_snuhdipoTUXMus_bzTZqCHxuUVRNs9LfEkM_iVuQo3Rql8Gblp9sO-QAx_ZkiT6X1y0HX52mFOhghClcaSsYy-f4auwxyHvMpMCSkZFUJk6tOOcjGkFKF9aAYjs7GSeWYls7GS2Vopi98-HudBem8c-hdVQs7j</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2667743666</pqid></control><display><type>article</type><title>Association of Preeclampsia and Perinatal Complications With Offspring Neurodevelopmental and Psychiatric Disorders</title><source>MEDLINE</source><source>DOAJ Directory of Open Access Journals</source><source>SWEPUB Freely available online</source><source>EZB-FREE-00999 freely available EZB journals</source><source>Alma/SFX Local Collection</source><creator>Kong, Linghua ; Chen, Xinxia ; Liang, Yajun ; Forsell, Yvonne ; Gissler, Mika ; Lavebratt, Catharina</creator><creatorcontrib>Kong, Linghua ; Chen, Xinxia ; Liang, Yajun ; Forsell, Yvonne ; Gissler, Mika ; Lavebratt, Catharina</creatorcontrib><description>Maternal preeclampsia has been reported to increase the risk of autism spectrum disorder, attention-deficit/hyperactivity disorder (ADHD), and intellectual disability in offspring. However, the association between maternal preeclampsia combined with perinatal complications and neurodevelopmental and psychiatric disorders in offspring is less well documented.
To examine the association of maternal preeclampsia, separately and together with perinatal complications, with neurodevelopmental and psychiatric disorders in offspring.
This population-based cohort study used data from nationwide registries in Finland to assess all singleton live births (N = 1 012 723) between January 1, 1996, and December 31, 2014. Offspring were followed up until December 31, 2018 (when the oldest reached age 22 years). Exclusion criteria were maternal inpatient psychiatric diagnoses and pregestational diabetes. The study and data analysis were conducted from May 1, 2020, to June 1, 2021.
Preeclampsia and perinatal complications (delivery earlier than 34 weeks' gestation and/or small for gestational age).
The primary outcomes were neurodevelopmental and psychiatric diagnoses and dispensation of psychotropic drugs among offspring until December 31, 2018. Cox proportional hazards regression analyses were performed to assess the associations.
Of 1 012 723 singleton live births (51.1% boys; mean [SD] maternal age at birth, 30.0 [5.4] years; specific data on race and ethnicity were not available in the data set), 21 010 children (2.1%) were exposed to preeclampsia alone, 33 625 children (3.3%) were exposed to perinatal complications alone, and 4891 children (0.5%) were exposed to both preeclampsia and perinatal complications. A total of 93 281 children (9.2%) were diagnosed with a neurodevelopmental or psychiatric disorder. Offspring exposed to both preeclampsia and perinatal complications had an increased risk of any neurodevelopmental or psychiatric disorder after adjusting for potential confounding (adjusted hazard ratio [aHR], 2.11; 95% CI, 1.96-2.26) compared with those not exposed to either preeclampsia or perinatal complications; this risk was higher than exposure to either preeclampsia alone (aHR, 1.18; 95% CI, 1.12-1.23) or perinatal complications alone (aHR, 1.77; 95% CI, 1.72-1.82). Sibling pair analyses did not detect any increase in the risk of neurodevelopmental or psychiatric disorders after exposure to preeclampsia alone, but offspring exposed to both preeclampsia and perinatal complications had increased risks of intellectual disabilities (aHR, 3.24; 95% CI, 1.05-10.06), specific developmental disorders (aHR, 3.56; 95% CI, 2.35-5.41), ADHD and conduct disorders (aHR, 2.42; 95% CI, 1.09-5.39), and other behavioral and emotional disorders (aHR, 2.45; 95% CI, 1.17-5.13). The risk estimates for specific developmental disorders (aHR, 2.82; 95% CI, 2.60-3.05) and ADHD and conduct disorders (aHR, 1.88; 95% CI, 1.65-2.14) were higher among offspring exposed to both preeclampsia and perinatal complications compared with those exposed to perinatal complications alone (aHR, 2.26 [95% CI, 2.18-2.33] and 1.60 [95% CI, 1.52-1.68], respectively).
In this study, exposure to both maternal preeclampsia and perinatal complications was associated with intellectual disabilities, specific developmental disorders, ADHD and conduct disorders, and other behavioral and emotional disorders in offspring. For specific developmental disorders and ADHD and conduct disorders, the risk estimates were higher among offspring exposed to both preeclampsia and perinatal complications compared with those exposed to perinatal complications only.</description><identifier>ISSN: 2574-3805</identifier><identifier>EISSN: 2574-3805</identifier><identifier>DOI: 10.1001/jamanetworkopen.2021.45719</identifier><identifier>PMID: 35089349</identifier><language>eng</language><publisher>United States: American Medical Association</publisher><subject>Adult ; Attention Deficit Disorder with Hyperactivity - epidemiology ; Attention Deficit Disorder with Hyperactivity - etiology ; Attention deficit hyperactivity disorder ; Child ; Developmental Disabilities - epidemiology ; Developmental Disabilities - etiology ; Emotional disorders ; Female ; Finland - epidemiology ; Humans ; Infant, Newborn ; Intellectual disabilities ; Intellectual Disability - epidemiology ; Intellectual Disability - etiology ; Medicin och hälsovetenskap ; Mental disorders ; Mental Disorders - epidemiology ; Mental Disorders - etiology ; Neurodevelopmental Disorders - epidemiology ; Neurodevelopmental Disorders - etiology ; Online Only ; Original Investigation ; Pre-Eclampsia - psychology ; Preeclampsia ; Pregnancy ; Pregnancy Complications - psychology ; Prenatal Exposure Delayed Effects - epidemiology ; Prenatal Exposure Delayed Effects - etiology ; Proportional Hazards Models ; Psychiatry ; Registries</subject><ispartof>JAMA network open, 2022-01, Vol.5 (1), p.e2145719-e2145719</ispartof><rights>2022. This work is published under https://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>Copyright 2022 Kong L et al. .</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-a561t-92c0ae754da9ff83f0a1b3e1e547bd08bd3954e9eb7047b006d8b55374267a293</citedby><cites>FETCH-LOGICAL-a561t-92c0ae754da9ff83f0a1b3e1e547bd08bd3954e9eb7047b006d8b55374267a293</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,552,780,784,864,885,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/35089349$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttp://kipublications.ki.se/Default.aspx?queryparsed=id:148679597$$DView record from Swedish Publication Index$$Hfree_for_read</backlink></links><search><creatorcontrib>Kong, Linghua</creatorcontrib><creatorcontrib>Chen, Xinxia</creatorcontrib><creatorcontrib>Liang, Yajun</creatorcontrib><creatorcontrib>Forsell, Yvonne</creatorcontrib><creatorcontrib>Gissler, Mika</creatorcontrib><creatorcontrib>Lavebratt, Catharina</creatorcontrib><title>Association of Preeclampsia and Perinatal Complications With Offspring Neurodevelopmental and Psychiatric Disorders</title><title>JAMA network open</title><addtitle>JAMA Netw Open</addtitle><description>Maternal preeclampsia has been reported to increase the risk of autism spectrum disorder, attention-deficit/hyperactivity disorder (ADHD), and intellectual disability in offspring. However, the association between maternal preeclampsia combined with perinatal complications and neurodevelopmental and psychiatric disorders in offspring is less well documented.
To examine the association of maternal preeclampsia, separately and together with perinatal complications, with neurodevelopmental and psychiatric disorders in offspring.
This population-based cohort study used data from nationwide registries in Finland to assess all singleton live births (N = 1 012 723) between January 1, 1996, and December 31, 2014. Offspring were followed up until December 31, 2018 (when the oldest reached age 22 years). Exclusion criteria were maternal inpatient psychiatric diagnoses and pregestational diabetes. The study and data analysis were conducted from May 1, 2020, to June 1, 2021.
Preeclampsia and perinatal complications (delivery earlier than 34 weeks' gestation and/or small for gestational age).
The primary outcomes were neurodevelopmental and psychiatric diagnoses and dispensation of psychotropic drugs among offspring until December 31, 2018. Cox proportional hazards regression analyses were performed to assess the associations.
Of 1 012 723 singleton live births (51.1% boys; mean [SD] maternal age at birth, 30.0 [5.4] years; specific data on race and ethnicity were not available in the data set), 21 010 children (2.1%) were exposed to preeclampsia alone, 33 625 children (3.3%) were exposed to perinatal complications alone, and 4891 children (0.5%) were exposed to both preeclampsia and perinatal complications. A total of 93 281 children (9.2%) were diagnosed with a neurodevelopmental or psychiatric disorder. Offspring exposed to both preeclampsia and perinatal complications had an increased risk of any neurodevelopmental or psychiatric disorder after adjusting for potential confounding (adjusted hazard ratio [aHR], 2.11; 95% CI, 1.96-2.26) compared with those not exposed to either preeclampsia or perinatal complications; this risk was higher than exposure to either preeclampsia alone (aHR, 1.18; 95% CI, 1.12-1.23) or perinatal complications alone (aHR, 1.77; 95% CI, 1.72-1.82). Sibling pair analyses did not detect any increase in the risk of neurodevelopmental or psychiatric disorders after exposure to preeclampsia alone, but offspring exposed to both preeclampsia and perinatal complications had increased risks of intellectual disabilities (aHR, 3.24; 95% CI, 1.05-10.06), specific developmental disorders (aHR, 3.56; 95% CI, 2.35-5.41), ADHD and conduct disorders (aHR, 2.42; 95% CI, 1.09-5.39), and other behavioral and emotional disorders (aHR, 2.45; 95% CI, 1.17-5.13). The risk estimates for specific developmental disorders (aHR, 2.82; 95% CI, 2.60-3.05) and ADHD and conduct disorders (aHR, 1.88; 95% CI, 1.65-2.14) were higher among offspring exposed to both preeclampsia and perinatal complications compared with those exposed to perinatal complications alone (aHR, 2.26 [95% CI, 2.18-2.33] and 1.60 [95% CI, 1.52-1.68], respectively).
In this study, exposure to both maternal preeclampsia and perinatal complications was associated with intellectual disabilities, specific developmental disorders, ADHD and conduct disorders, and other behavioral and emotional disorders in offspring. For specific developmental disorders and ADHD and conduct disorders, the risk estimates were higher among offspring exposed to both preeclampsia and perinatal complications compared with those exposed to perinatal complications only.</description><subject>Adult</subject><subject>Attention Deficit Disorder with Hyperactivity - epidemiology</subject><subject>Attention Deficit Disorder with Hyperactivity - etiology</subject><subject>Attention deficit hyperactivity disorder</subject><subject>Child</subject><subject>Developmental Disabilities - epidemiology</subject><subject>Developmental Disabilities - etiology</subject><subject>Emotional disorders</subject><subject>Female</subject><subject>Finland - epidemiology</subject><subject>Humans</subject><subject>Infant, Newborn</subject><subject>Intellectual disabilities</subject><subject>Intellectual Disability - epidemiology</subject><subject>Intellectual Disability - etiology</subject><subject>Medicin och hälsovetenskap</subject><subject>Mental disorders</subject><subject>Mental Disorders - epidemiology</subject><subject>Mental Disorders - etiology</subject><subject>Neurodevelopmental Disorders - epidemiology</subject><subject>Neurodevelopmental Disorders - etiology</subject><subject>Online Only</subject><subject>Original Investigation</subject><subject>Pre-Eclampsia - psychology</subject><subject>Preeclampsia</subject><subject>Pregnancy</subject><subject>Pregnancy Complications - psychology</subject><subject>Prenatal Exposure Delayed Effects - epidemiology</subject><subject>Prenatal Exposure Delayed Effects - etiology</subject><subject>Proportional Hazards Models</subject><subject>Psychiatry</subject><subject>Registries</subject><issn>2574-3805</issn><issn>2574-3805</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>D8T</sourceid><recordid>eNp1kstu1TAQhiMEolXpK6AINmxy8P3CAqk6QItU0S5ALC3HmfT4NImDnbTq2-NzaWkrsfLI8_2jufxF8Q6jBUYIf1zb3g4w3YZ4HUYYFgQRvGBcYv2iOCRcsooqxF8-ig-K45TWCCGCMNWCvy4OKEdKU6YPi3SSUnDeTj4MZWjLywjgOtuPydvSDk15CdEPdrJduQz92Hm3RVP520-r8qJt05jzV-UPmGNo4Aa6MPYwbPitOt25Va4evSu_-BRiAzG9KV61tktwvH-Pil_fvv5cnlXnF6fflyfnleUCT5UmDlmQnDVWt62iLbK4poCBM1k3SNUN1ZyBhlqi_IOQaFTNOZWMCGmJpkdFtaubbmGca5M77W28M8F6s_-6zhEYxrlGNPP6v_yYp_snuhdipoTUXMus_bzTZqCHxuUVRNs9LfEkM_iVuQo3Rql8Gblp9sO-QAx_ZkiT6X1y0HX52mFOhghClcaSsYy-f4auwxyHvMpMCSkZFUJk6tOOcjGkFKF9aAYjs7GSeWYls7GS2Vopi98-HudBem8c-hdVQs7j</recordid><startdate>20220104</startdate><enddate>20220104</enddate><creator>Kong, Linghua</creator><creator>Chen, Xinxia</creator><creator>Liang, Yajun</creator><creator>Forsell, Yvonne</creator><creator>Gissler, Mika</creator><creator>Lavebratt, Catharina</creator><general>American Medical Association</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope><scope>ADTPV</scope><scope>AOWAS</scope><scope>D8T</scope><scope>ZZAVC</scope></search><sort><creationdate>20220104</creationdate><title>Association of Preeclampsia and Perinatal Complications With Offspring Neurodevelopmental and Psychiatric Disorders</title><author>Kong, Linghua ; Chen, Xinxia ; Liang, Yajun ; Forsell, Yvonne ; Gissler, Mika ; Lavebratt, Catharina</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-a561t-92c0ae754da9ff83f0a1b3e1e547bd08bd3954e9eb7047b006d8b55374267a293</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Adult</topic><topic>Attention Deficit Disorder with Hyperactivity - epidemiology</topic><topic>Attention Deficit Disorder with Hyperactivity - etiology</topic><topic>Attention deficit hyperactivity disorder</topic><topic>Child</topic><topic>Developmental Disabilities - epidemiology</topic><topic>Developmental Disabilities - etiology</topic><topic>Emotional disorders</topic><topic>Female</topic><topic>Finland - epidemiology</topic><topic>Humans</topic><topic>Infant, Newborn</topic><topic>Intellectual disabilities</topic><topic>Intellectual Disability - epidemiology</topic><topic>Intellectual Disability - etiology</topic><topic>Medicin och hälsovetenskap</topic><topic>Mental disorders</topic><topic>Mental Disorders - epidemiology</topic><topic>Mental Disorders - etiology</topic><topic>Neurodevelopmental Disorders - epidemiology</topic><topic>Neurodevelopmental Disorders - etiology</topic><topic>Online Only</topic><topic>Original Investigation</topic><topic>Pre-Eclampsia - psychology</topic><topic>Preeclampsia</topic><topic>Pregnancy</topic><topic>Pregnancy Complications - psychology</topic><topic>Prenatal Exposure Delayed Effects - epidemiology</topic><topic>Prenatal Exposure Delayed Effects - etiology</topic><topic>Proportional Hazards Models</topic><topic>Psychiatry</topic><topic>Registries</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kong, Linghua</creatorcontrib><creatorcontrib>Chen, Xinxia</creatorcontrib><creatorcontrib>Liang, Yajun</creatorcontrib><creatorcontrib>Forsell, Yvonne</creatorcontrib><creatorcontrib>Gissler, Mika</creatorcontrib><creatorcontrib>Lavebratt, Catharina</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>SwePub</collection><collection>SwePub Articles</collection><collection>SWEPUB Freely available online</collection><collection>SwePub Articles full text</collection><jtitle>JAMA network open</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kong, Linghua</au><au>Chen, Xinxia</au><au>Liang, Yajun</au><au>Forsell, Yvonne</au><au>Gissler, Mika</au><au>Lavebratt, Catharina</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Association of Preeclampsia and Perinatal Complications With Offspring Neurodevelopmental and Psychiatric Disorders</atitle><jtitle>JAMA network open</jtitle><addtitle>JAMA Netw Open</addtitle><date>2022-01-04</date><risdate>2022</risdate><volume>5</volume><issue>1</issue><spage>e2145719</spage><epage>e2145719</epage><pages>e2145719-e2145719</pages><issn>2574-3805</issn><eissn>2574-3805</eissn><abstract>Maternal preeclampsia has been reported to increase the risk of autism spectrum disorder, attention-deficit/hyperactivity disorder (ADHD), and intellectual disability in offspring. However, the association between maternal preeclampsia combined with perinatal complications and neurodevelopmental and psychiatric disorders in offspring is less well documented.
To examine the association of maternal preeclampsia, separately and together with perinatal complications, with neurodevelopmental and psychiatric disorders in offspring.
This population-based cohort study used data from nationwide registries in Finland to assess all singleton live births (N = 1 012 723) between January 1, 1996, and December 31, 2014. Offspring were followed up until December 31, 2018 (when the oldest reached age 22 years). Exclusion criteria were maternal inpatient psychiatric diagnoses and pregestational diabetes. The study and data analysis were conducted from May 1, 2020, to June 1, 2021.
Preeclampsia and perinatal complications (delivery earlier than 34 weeks' gestation and/or small for gestational age).
The primary outcomes were neurodevelopmental and psychiatric diagnoses and dispensation of psychotropic drugs among offspring until December 31, 2018. Cox proportional hazards regression analyses were performed to assess the associations.
Of 1 012 723 singleton live births (51.1% boys; mean [SD] maternal age at birth, 30.0 [5.4] years; specific data on race and ethnicity were not available in the data set), 21 010 children (2.1%) were exposed to preeclampsia alone, 33 625 children (3.3%) were exposed to perinatal complications alone, and 4891 children (0.5%) were exposed to both preeclampsia and perinatal complications. A total of 93 281 children (9.2%) were diagnosed with a neurodevelopmental or psychiatric disorder. Offspring exposed to both preeclampsia and perinatal complications had an increased risk of any neurodevelopmental or psychiatric disorder after adjusting for potential confounding (adjusted hazard ratio [aHR], 2.11; 95% CI, 1.96-2.26) compared with those not exposed to either preeclampsia or perinatal complications; this risk was higher than exposure to either preeclampsia alone (aHR, 1.18; 95% CI, 1.12-1.23) or perinatal complications alone (aHR, 1.77; 95% CI, 1.72-1.82). Sibling pair analyses did not detect any increase in the risk of neurodevelopmental or psychiatric disorders after exposure to preeclampsia alone, but offspring exposed to both preeclampsia and perinatal complications had increased risks of intellectual disabilities (aHR, 3.24; 95% CI, 1.05-10.06), specific developmental disorders (aHR, 3.56; 95% CI, 2.35-5.41), ADHD and conduct disorders (aHR, 2.42; 95% CI, 1.09-5.39), and other behavioral and emotional disorders (aHR, 2.45; 95% CI, 1.17-5.13). The risk estimates for specific developmental disorders (aHR, 2.82; 95% CI, 2.60-3.05) and ADHD and conduct disorders (aHR, 1.88; 95% CI, 1.65-2.14) were higher among offspring exposed to both preeclampsia and perinatal complications compared with those exposed to perinatal complications alone (aHR, 2.26 [95% CI, 2.18-2.33] and 1.60 [95% CI, 1.52-1.68], respectively).
In this study, exposure to both maternal preeclampsia and perinatal complications was associated with intellectual disabilities, specific developmental disorders, ADHD and conduct disorders, and other behavioral and emotional disorders in offspring. For specific developmental disorders and ADHD and conduct disorders, the risk estimates were higher among offspring exposed to both preeclampsia and perinatal complications compared with those exposed to perinatal complications only.</abstract><cop>United States</cop><pub>American Medical Association</pub><pmid>35089349</pmid><doi>10.1001/jamanetworkopen.2021.45719</doi><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; DOAJ Directory of Open Access Journals; SWEPUB Freely available online; EZB-FREE-00999 freely available EZB journals; Alma/SFX Local Collection |
| subjects | Adult Attention Deficit Disorder with Hyperactivity - epidemiology Attention Deficit Disorder with Hyperactivity - etiology Attention deficit hyperactivity disorder Child Developmental Disabilities - epidemiology Developmental Disabilities - etiology Emotional disorders Female Finland - epidemiology Humans Infant, Newborn Intellectual disabilities Intellectual Disability - epidemiology Intellectual Disability - etiology Medicin och hälsovetenskap Mental disorders Mental Disorders - epidemiology Mental Disorders - etiology Neurodevelopmental Disorders - epidemiology Neurodevelopmental Disorders - etiology Online Only Original Investigation Pre-Eclampsia - psychology Preeclampsia Pregnancy Pregnancy Complications - psychology Prenatal Exposure Delayed Effects - epidemiology Prenatal Exposure Delayed Effects - etiology Proportional Hazards Models Psychiatry Registries |
| title | Association of Preeclampsia and Perinatal Complications With Offspring Neurodevelopmental and Psychiatric Disorders |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-05T21%3A29%3A14IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_swepu&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Association%20of%20Preeclampsia%20and%20Perinatal%20Complications%20With%20Offspring%20Neurodevelopmental%20and%20Psychiatric%20Disorders&rft.jtitle=JAMA%20network%20open&rft.au=Kong,%20Linghua&rft.date=2022-01-04&rft.volume=5&rft.issue=1&rft.spage=e2145719&rft.epage=e2145719&rft.pages=e2145719-e2145719&rft.issn=2574-3805&rft.eissn=2574-3805&rft_id=info:doi/10.1001/jamanetworkopen.2021.45719&rft_dat=%3Cproquest_swepu%3E2667743666%3C/proquest_swepu%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2667743666&rft_id=info:pmid/35089349&rfr_iscdi=true |