Maternal Hypertensive Pregnancy Disorders and Mental and Behavioral Disorders in the Offspring: a Review

Rachel Robinson,Jari Lahti,Anna Lähdepuro,Kati Heinonen,Polina Girchenko,Soile Tuovinen,Ville Rantalainen,Katri Räikkönen,Marius Lahti-Pulkkinen

doi:10.1007/s11906-021-01141-w

Abstract

Purpose of ReviewWe review here recent original research and meta-analytic evidence on the associations of maternal hypertensive pregnancy disorders and mental and behavioral disorders in the offspring.Recent FindingsSeven meta-analyses and 11 of 16 original research studies published since 2015 showed significant associations between maternal hypertensive pregnancy disorders and offspring mental and behavioral disorders. Evidence was most consistent in meta-analyses and high-quality cohort studies. The associations, independent of familial confounding, were observed on different mental and behavioral disorders in childhood and schizophrenia in adulthood. Preterm birth and small-for-gestational age birth emerged as possible moderators and mediators of the associations. Cross-sectional and case-control studies yielded inconsistent findings, but had lower methodological quality.SummaryAccumulating evidence from methodologically sound studies shows that maternal hypertensive pregnancy disorders are associated with an increased risk of mental and behavioral disorders in the offspring in childhood. More studies on adult mental disorders are needed.

Highlights

Hypertensive pregnancy disorders, including chronic hypertension, gestational hypertension, preeclampsia, and eclampsia complicate up to 5–8% of all pregnancies [1]
A large amount of recent research has focused on the associations of maternal hypertensive pregnancy disorders on offspring mental disorders
The evidence from cohort studies and meta-analyses is increasingly consistent in suggesting that maternal hypertensive pregnancy disorders are associated with increased risks of a wide range of different mental and behavioral disorders in childhood and adolescence, and schizophrenia in adulthood

Summary

Introduction

Hypertensive pregnancy disorders, including chronic hypertension, gestational hypertension, preeclampsia, and eclampsia complicate up to 5–8% of all pregnancies [1]. In recent years, an increasing amount of studies have assessed the effects of maternal hypertensive pregnancy disorders on offspring mental and behavioral disorders [8,9,10,11,12,13,14]. In light of this and since earlier original research studies have been reviewed thoroughly in previous meta-analyses [15, 16, 17–22], we reviewed the recent evidence from metaanalytic and new original research studies on maternal hypertensive pregnancy disorders and offspring mental and behavioral disorders published since 2015. We focus here on diagnosed mental and behavioral disorders, as classified in the International Classification of Diseases and Related Conditions, Tenth Revision (ICD-10) with diagnostic codes F00-F99, as outcomes [23]

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Discussion

Conclusion