Abstract
BackgroundHypertensive disorders complicate up to 10% of pregnancies. Evidence suggests a potential association between maternal hypertensive disorders during pregnancy, particularly preeclampsia, and adverse neurodevelopment in the offspring, but existing studies are subject to limitations. We aimed to assess whether in-utero exposure to preeclampsia/eclampsia negatively impacts academic performance at ages 9, 12 and 15 years.MethodsUsing individually linked, nationwide data from the Icelandic registries we followed all children born in 1989–2004 (N = 68,580), from birth until the end of 2014, thereof 63,014 (91.9%) took at least one standardized test. Using a stepwise, mixed-effects approach, we modelled the hypothesized relationship while adjusting for maternal, perinatal and childhood variables of interest. We compared test scores, measured on a normalized scale ranging from 0–60 with a mean of 30 and a standard deviation of 10, in the 4th, 7th, and 10th grades, between children exposed to preeclampsia or eclampsia in-utero versus children from normotensive pregnancies in the population.ResultsChildren exposed to preeclampsia/eclampsia scored lower than those unexposed in mathematics across all grade levels, corresponding to a difference of 0.44 points (95% CI: 0.00, 0.89), 0.59 points (95% CI: 0.13, 1.06) and 0.59 points (95% CI: 0.08, 1.10), respectively. No differences were observed in the language arts.ConclusionsOur findings suggest a minimal effect of maternal preeclampsia/eclampsia on children’s academic performance at ages 9, 12 and 15 years. The differences observed in mathematic scores between exposed and unexposed children were minimal, less than one tenth of a standard deviation per measurement occasion.
Highlights
Hypertensive disorders of pregnancy, which complicate up to 10% of pregnancies [1, 2], account for a substantial proportion of maternal and neonatal morbidity and mortality worldwide[3,4,5,6,7]
Children exposed to preeclampsia/eclampsia scored lower than those unexposed in mathematics across all grade levels, corresponding to a difference of 0.44 points, 0.59 points and 0.59 points, respectively
Preeclampsia and academic performance were accessed in above manner and the authors confirm that they did not enjoy any special privileges which would preclude others from obtaining the data
Summary
Hypertensive disorders of pregnancy, which complicate up to 10% of pregnancies [1, 2], account for a substantial proportion of maternal and neonatal morbidity and mortality worldwide[3,4,5,6,7]. But not all [8], studies have suggested that hypertensive disorders during pregnancy may adversely affect neurodevelopment during childhood and into early adulthood, including IQ scores[9,10,11,12,13] and verbal ability [14, 15]. The etiology behind this relationship is largely unclear, but preeclampsia has been associated with an adverse intrauterine environment characterized by ischemia and reduced placental blood flow which may, in turn, lead to lower neurodevelopmental functioning [16]. We aimed to assess whether in-utero exposure to preeclampsia/eclampsia negatively impacts academic performance at ages 9, 12 and 15 years.
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