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BJOG. 2014 Nov;121(12):1482-91. doi: 10.1111/1471-0528.12753. Epub 2014 Apr 7.

Maternal hypertensive disorders during pregnancy: adaptive functioning and psychiatric and psychological problems of the older offspring.

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1
Institute of Behavioural Sciences, University of Helsinki, Helsinki, Finland.

Abstract

OBJECTIVE:

To study whether pre-eclampsia and hypertension without proteinuria during pregnancy are associated with adaptive functioning, and psychiatric and psychological problems, of older offspring.

DESIGN:

Retrospective longitudinal cohort study.

SETTING:

Participants in the Helsinki Birth Cohort 1934-44 Study.

POPULATION:

A cohort of 778 participants born after normotensive, pre-eclamptic, or hypertensive pregnancies, defined based on the mother's blood pressure and urinary protein measurements at maternity clinics and birth hospitals.

METHODS:

Pearson's chi-squared tests and multivariable logistic regression.

MAIN OUTCOME MEASURES:

Achenbach System of Empirically Based Assessment Older Adult Self-Report scores, completed at age 69.3 years (SD 3.1 years).

RESULTS:

Compared with offspring born after normotensive pregnancies, offspring born after pre-eclamptic pregnancies had increased odds of reporting total problems (aOR 4.00, 95%CI 1.64-9.77) and problems of particular concern to clinicians (critical items; aOR 5.28, 95%CI 1.87-14.96), as well as: anxious/depressed, functional impairment, memory, thought, and irritable/disinhibited problems on syndrome scales; depressive, somatic, and psychotic problems on Diagnostic and Statistical Manual of Mental Disorders scales; and adjustment problems in relationship satisfaction with spouse/partner. Maternal hypertension without proteinuria was not consistently associated with adjustment and problems (total problems, aOR 1.08, 95%CI 0.75-1.57; critical items, aOR 1.58, 95%CI 0.91-2.72).

CONCLUSIONS:

Maternal hypertensive disorders in pregnancy, during a period of expectant treatment, carry an increased risk of problems in adaptive functioning and mental wellbeing in the offspring seven decades later. Being the longest follow-up on transgenerational consequences of maternal hypertensive disorders reported thus far, our study points to the life-time increased risk of an adverse intrauterine environment.

KEYWORDS:

Adaptive functioning; hypertension; late adulthood; offspring; pre-eclampsia; psychiatric and psychological problems

PMID:
24703162
DOI:
10.1111/1471-0528.12753
[Indexed for MEDLINE]
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