Monday, March 22, 2021

Hypertension During Pregnancy May Increase Risk of Neurodevelopmental Disorders in Children

Women experiencing hypertensive disorders during pregnancy may be at a higher risk of having children with autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD) than those without hypertensive disorders, reports a study published today in JAMA Pediatrics.

Judith S. Brand, Ph.D., of Örebro University in Sweden and colleagues analyzed health registry data of over 1 million individuals born in Sweden between 1987 and 1996 to identify associations between maternal hypertensive disorders (chronic hypertension, gestational-onset hypertension, or preeclampsia) and neurodevelopmental disorders in children. They also used data from over 285,000 men born between 1982 and 1992 who underwent military medical assessments at age 18 to examine the association between maternal hypertensive disorders and future cognitive performance; the military assessments included a full battery of cognitive tests.

Overall, 4% of the mothers of the health registry cohort and 5% of the mothers of the military cohort had a hypertensive disorder during pregnancy. After adjusting for various health and demographic factors, Brand and colleagues found that a maternal hypertensive disorder was associated with a 22% increased risk of ASD, 10% increased risk of ADHD, and 39% increased risk of intellectual disability in offspring. In the military cohort, maternal hypertensive disorders were associated with lower scores on the cognitive performance tests.

Brand and colleagues next analyzed outcomes only among siblings who were born under different maternal conditions (for example, a mother had two children but only had a hypertensive disorder during one of the pregnancies). They found that ASD and ADHD risks remained the same as were seen in the larger sample, but there was no longer any increased risk of intellectual disability or lower cognitive function due to maternal hypertensive disorders.

“Together, these results suggest that, while modestly increased risks of ASDs, and possibly ADHD, may be explained by intrauterine effects of [hypertensive disorders in pregnancy], associations with ID [intellectual disability] and cognitive performance are likely confounded by unmeasured shared familial (environmental or genetic) factors,” the authors wrote.

To read more about this topic, see the Psychiatric News article “Anxiety Linked to Hypertensive Disorders in Pregnancy.”

(Image: iStock/AndreyPopov)




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Resident-fellow members are urged to register for the APA Presidential Task Force to Address Structural Racism Throughout Psychiatry for a discussion on the task force’s work and opportunities to get involved as the work continues. The event will be held tomorrow, Tuesday, March 23, at 7 p.m. ET.

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