1. Maternal preeclampsia at term was associated with an increased risk of neurodevelopmental disorders in offspring.
Evidence Rating: 1 (Excellent)
While the risks associated with preeclampsia are well established for the mother, the associated outcomes and risks for the offspring are relatively less well characterized. Preeclampsia has previously been linked to cerebral palsy, autism spectrum disorder (ASD), and attention-deficit/hyperactivity disorder (ADHD) in offspring, but few studies have distinguished between term and preterm preeclampsia. In this prospective cohort study, researchers investigated the association between maternal preeclampsia in term births with a variety of neurodevelopmental disorders in a cohort of 980,560 Norwegian offspring born at term between 1991 and 2009. Among the children included in the study, 28,068 (2.9%) were exposed to preeclampsia in utero, with 273 cases progressing to eclampsia. During a mean follow up period of 14.0 (SD 5.6) years, offspring exposed to preeclampsia prior to birth were found to have a higher risk of ADHD (adjusted OR, 1.18; 95% CI, 1.05-1.330, ASD (adjusted OR, 1.29; 95% CI, 1.08-1.54), epilepsy (adjusted OR, 1.50; 95% CI, 1.16-1.93), and intellectual disability (adjusted OR, 1.50; 95% CI, 1.13-1.97), with a trend toward a higher risk of cerebral palsy (adjusted OR, 1.30; 95% CI, 0.94-1.80). Analyses were made with adjustment for sex, year of birth, maternal age, parity, and other potentially confounding factors. Although these outcomes were still rare among the cohort, this study represents the most comprehensive investigation evaluating the association between maternal preeclampsia and neurodevelopment to date, and provides evidence that preeclampsia may have broad effects on neurodevelopment independent of preterm birth. Further investigation of this association may provide a basis for screening or intervention in the future for the benefit of offspring born under these conditions.