Pre-eclampsia—An additional risk factor for cognitive impairment at school age after intrauterine growth restriction and very preterm birth

Abstract

ObjectiveTo explore the possible influence of pre-eclampsia on cognitive outcome in children born very preterm after intrauterine growth restriction (IUGR) and abnormal umbilical artery blood flow. MethodsCognitive function was evaluated at 5–8years of age with Wechsler scales in 34 children born before 30gestationalweeks after IUGR (PT-IUGR) (11 children were exposed to maternal pre-eclampsia, 23 non-exposed) and in 34 children with no maternal pre-eclampsia and birth weight appropriate-for-gestational age (PT-AGA) matched for gestational age at birth, gender and age at examination. ResultsThe subjects in the PT-IUGR group exposed to maternal pre-eclampsia had lower mean verbal IQ (VIQ) (mean±SD 74±16) and lower full scale IQ (FSIQ) (70±19) in comparison with both the non-exposed PT-IUGR (VIQ 89±15; p=0.013; FSIQ 83±14, p=0.029), and, the PT-AGA group (VIQ 96±15, p<0.001; FSIQ 90±14, p=0.001). The differences remained significant after adjustment for known confounders. VIQ and FSIQ did not differ between the non-exposed IUGR and PT-AGA children. ConclusionFetal exposure to maternal pre-eclampsia seems to have an additional negative impact to that of IUGR on cognitive function in children born very preterm.