May 1, 2020 / 11:08 PM / 3 months ago

Preeclampsia, hypertension tied to mental health conditions in children

(Reuters Health) - Preeclampsia is associated with increased risk of any childhood mental disorder in offspring, as well as child psychological, behavioral, and emotional disorders, a study in Finland suggests.

Researchers examined whether maternal hypertensive pregnancy disorders and maximum blood pressure during pregnancy predicted mental disorders in children, based on data from 4,743 mother-child pairs, with children born from 2006 to 2010 and followed until they were 6.4 to 10.8 years old.

Compared to women with normal blood pressure during pregnancy, women with preeclampsia were more likely to have offspring with childhood mental disorders (hazard ratio 1.66), psychological development disorders (HR 1.87), and behavioral or emotional disorders (HR 1.97).

With severe preeclampsia, the risk was doubled for any childhood mental disorder and more than doubled for psychological development disorders and behavioral and emotional disorders.

The associations were independent of all covariates, the authors report in Hypertension.

“Maternal hypertensive pregnancy disorders can have long-lasting adverse effects not only on the health of the mother, but also for the somatic and mental health of the offspring,” said coauthor Marius Lahti-Pulkkinen of the University of Helsinki.

“Efforts need to be taken to provide optimal antenatal care and support for all expectant mothers, and provide support for affected women and families,” Lahti-Pulkkinen said by email.

International guidelines suggest several promising prevention and treatment strategies for hypertensive pregnancy disorders and particularly preeclampsia, Lahti-Pulkkinen noted.

“These include aspirin, magnesium sulfate, and antihypertensive drug treatment, exercise and clinical monitoring of intrauterine growth restriction and preeclampsia risks,” Lahti-Pulkkinen said. “While these treatments are not universally effective, they do show clear positive effects for many affected individuals, and our findings suggest that such interventions may benefit both maternal and offspring well-being.”

The combination of maternal hypertensive disorders with other medical problems also increased the incidence of childhood mental disorders, the study found.

Compared to women at a healthy weight without hypertension, women with one adverse pregnancy condition such as obesity or type 2 diabetes were 42% more likely to have offspring with childhood mental disorders in general, and psychological development disorders, in particular.

When women had hypertensive disorders and two additional adverse pregnancy conditions, the incidence of any childhood mental disorder rose from 6% to 22%, the authors note.

The associations of maternal preeclampsia with offspring childhood mental disorders are not explained by maternal mental disorders, age, substance use, number of previous pregnancies, education, overweight/obesity or diabetes disorders or paternal mental or hypertensive disorders.

One limitation of the study is that researchers had maternal blood pressure data only for a subsample, and subsample was a high-risk sample for preeclampsia, limiting generalizability.

Another limitation is that some childhood mental disorders, including schizophrenia, mood, and substance use disorders, usually have their onset beyond the follow-up period of the study.

Even so, the results underscore how important it is for expecting mothers or those who want to become pregnant to work with the healthcare providers to manage blood pressure for the safety of the mother and unborn child, said Dr. Suzanne Steinbaum, a volunteer medial expert for the American Heart Association’s ‘Go Red for Women’ campaign.

“Research shows modest changes to diet and lifestyle can lower risk by as much as 80%, and it’s important that weight is monitored closely during pregnancy for women with hypertensive disorders,” Dr. Steinbaum, who wasn’t involved in the study, said by email. “Healthy weight gain is essential, but excessive weight gain needs to be controlled. Movement and exercise are critical to managing weight gain during pregnancy.”

SOURCE: Hypertension, online April 20, 2020.

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