Maternal Hypertensive Pregnancy Disorders and Mental Disorders in Children
Maternal Hypertensive Pregnancy Disorders and Mental Disorders in Children
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DOI：
10.1161/hypertensionaha.119.14140
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发表时间：
2020-06-01
期刊：
影响因子：
8.3
通讯作者：
Raikkonen, Katri
中科院分区：
文献类型：
--
作者：
Lahti-Pulkkinen, Marius;Girchenko, Polina;Raikkonen, Katri
母体妊娠期高血压疾病与子代精神障碍的关系尚不清楚。我们研究了母亲高血压疾病和怀孕期间的最高血压是否可以预测后代的儿童期精神疾病，这些关联是否独立于母亲和父亲的精神疾病和父亲的高血压疾病，独立于或添加母亲早期妊娠超重/肥胖和糖尿病疾病，以及由早产介导或调节，小于胎龄儿出生和新生儿重症监护室入院。我们的前瞻性研究包括4743对预测和预防先兆子痫和宫内生长受限研究的母子配对。在芬兰妇产医院招募怀孕早期的妇女参加这项研究。儿童出生于2006年至2010年，随访至2016年12月31日，年龄为6.4至10.8岁。高血压妊娠障碍是从医疗记录，医疗出生登记，和保健护理登记。在产前诊所和医院就诊时测量收缩压和舒张压。精神障碍诊断是从保健护理登记册中确定的。母亲妊娠期和慢性高血压，先兆子痫及其严重程度增加后代的任何儿童精神障碍的危险。先兆子痫（风险比=1.66 [95%CI，1.14-2.42]）和重度先兆子痫（风险比=2.01 [95%CI，1.08-3.73]）的相关性与所有协变量无关。母亲高血压和糖尿病疾病和超重/肥胖也增加了后代精神障碍的风险。早产和小于胎龄儿出生和新生儿重症监护室入院部分介导的任何和严重的先兆子痫对后代精神障碍的影响。总之，母亲的高血压妊娠障碍对后代的心理健康产生不良后果。
The associations of maternal hypertensive pregnancy disorders with offspring mental disorders remain unclear. We examined whether maternal hypertensive disorders and maximum blood pressure during pregnancy predict offspring childhood mental disorders, whether the associations are independent of maternal and paternal mental disorders and paternal hypertensive disorders, independent of or additive with maternal early pregnancy overweight/obesity and diabetes mellitus disorders, and mediated or moderated by preterm birth, small-for-gestational-age birth and neonatal intensive care unit admission. Our prospective study comprised 4743 mother-child dyads of Prediction and Prevention of Preeclampsia and Intrauterine Growth Restriction study. Women were recruited to the study in early pregnancy at Finnish maternity hospitals. Children were born 2006 to 2010 and followed-up until December 31, 2016, to ages 6.4 to 10.8 years. Hypertensive pregnancy disorders were identified from medical records, Medical Birth Register, and Care Register for Health Care. Systolic and diastolic blood pressure were measured at antenatal clinics and hospital visits. Mental disorder diagnoses were identified from Care Register for Health Care. Maternal gestational and chronic hypertension, preeclampsia and its severity increased offspring hazard of any childhood mental disorder. The associations of preeclampsia (hazard ratio=1.66 [95% CI, 1.14-2.42]) and severe preeclampsia (hazard ratio=2.01 [95% CI, 1.08-3.73]) were independent of all covariates. Maternal hypertensive and diabetes mellitus disorders and overweight/obesity also additively increased offspring hazard of mental disorders. Preterm and small-for-gestational-age births and neonatal intensive care unit admission partially mediated the effects of any and severe preeclampsia on offspring mental disorders. To conclude, maternal hypertensive pregnancy disorders carry adverse consequences for offspring mental health.