LATEBREAKER
Perinatal & Pediatric
Association between Hypertensive Disorders of Pregnancy and Child Developmental Pattern: TMM BirThree Cohort Study in Japan Geng Chen* Geng Chen Mami Ishikuro Hisashi Ohseto Aoi Noda Genki Shinoda Masatsugu Orui Taku Obara Shinichi Kuriyama
BACKGROUND
Hypertensive disorders of pregnancy (HDP), particularly preeclampsia (PE), is associated with increased risk of developmental delay in different ages of children. Child development problems at an early age could persist into later years. Identifying child development pattern which contributes to early intervention might help them catch up.
OBJECTIVES
To investigate child development pattern in 5 developmental domains. To reveal the association between fetus exposure to HDP or PE and child development pattern.
METHODS
The study included 11748 mother-child pairs from TMM BirThree Cohort Study, a prospective cohort study in Japan. HDP and PE prevalence were identified by antenatal records. The Ages and Stages Questionnaires, 3rd edition (ASQ-3) were collected at 6, 12, 24, 42, 48 months of age to measure child development in communication, gross motor, fine motor, problem solving and personal/social. Latent class trajectory model was applied to z-score-scaled ASQ-3 scores, fitting with 3 polynomial functions (linear, quadratic, cubic), refining class numbers from 2 to 7. After assessments, models with lowest Bayesian information criterion value were recognized best-fitting. Poisson regression analysis was conducted between HDP or PE and development patterns to calculate risk ratios (RRs), adjusted for maternal age at pregnancy, family annual income, maternal educational attainments, maternal pre-pregnancy BMI, parity, gestational diabetes mellitus prevalence, maternal tobacco use in pregnancy, maternal alcohol use in pregnancy, maternal folic acid intake in pregnancy and child sex.
RESULTS
The 3-class linear model fits the data best. Child development patterns could be described as normal, delay and catch-up. HDP prevalence is associated with delay pattern in gross motor (RR 1.28, 95% CI 1.06-1.53). PE prevalence is associated with delay pattern in communication (RR 1.42, 95% CI 1.00-1.96), gross motor (RR 1.51, 95% CI 1.07-2.07), and problem solving (RR 1.74, 95% CI 1.02-2.75).
CONCLUSION
In 5 domains, child development could be characterized into 3 patterns: normal, delay, and catch-up. Fetal exposure to HDP, particularly PE, is associated with a delay pattern in child development. We suggest screening from multiple domains in children exposed to PE during fetal stage to catch up.