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

• Published in: BJOG : an international journal of obstetrics and gynaecology Vol. 121; no. 12; pp. 1482 - 1491
• Main Authors: Tuovinen, S, Aalto‐Viljakainen, T, Eriksson, JG, Kajantie, E, Lahti, J, Pesonen, A‐K, Heinonen, K, Lahti, M, Osmond, C, Barker, DJP, Räikkönen, K
• Format: Journal Article
• Language: English
• Published: England Wiley Subscription Services, Inc 01.11.2014
• Subjects: Adaptation, Psychological; Adaptive functioning; Adult; Aged; Case-Control Studies; Female; Follow-Up Studies; Humans; Hypertension; Hypertension, Pregnancy-Induced; late adulthood; Logistic Models; Male; Mental disorders; Mental Disorders - etiology; Mental Disorders - psychology; Middle Aged; Obstetrics; offspring; Preeclampsia; Pregnancy; Prenatal Exposure Delayed Effects - etiology; Prenatal Exposure Delayed Effects - psychology; pre‐eclampsia; Proteinuria; psychiatric and psychological problems; Psychological Tests; Retrospective Studies; Risk Factors; Self Report; offspring; Adaptive functioning; pre-eclampsia; late adulthood; psychiatric and psychological problems; hypertension
• ISSN: 1470-0328; 1471-0528
• DOI: 10.1111/1471-0528.12753

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.