INFANT Research Centre, Cork, Ireland.
School of Public Health, Western Gateway Building, University College Cork, Cork, Ireland.
Matern Child Health J. 2020 Jun;24(6):727-738. doi: 10.1007/s10995-020-02921-7.
To examine the associations between preeclampsia and longitudinal child developmental and behavioural outcomes using data from a nationally representative study of children living in Ireland.
We used maternal-reported data from the Growing Up in Ireland longitudinal study of children. Data on preeclampsia and preeclampsia + small for gestational age (SGA) were collected when children were 9-months old. Data on child development and behavioural outcomes were collected at 9-months using the Ages and Stages Questionnaire (ASQ), and at 3 years, 5 years and 7-8 years using the Strengths and Difficulties Questionnaire (SDQ). Multivariate logistic regression analysis was used to examine the association between preeclampsia exposure and failure of ASQ domains, and abnormal SDQ domains. Linear spline multilevel models were used to examine the association between preeclampsia and preeclampsia + SGA and repeated measures of SDQ. All models controlled for several perinatal and sociodemographic factors.
A total of 10,692 children were included in the study at baseline, representing a weighted total of 70,791. Multivariate logistic regression suggested that preeclampsia was not associated with failing any ASQ domain. Preeclampsia was associated with abnormal SDQ cut-off of emotional (≥ 5) and hyperactivity (≥ 7) domains at age 5 years only. In the linear spline model, mean SDQ score was higher at each time point in exposed groups.
While we did not find strong evidence of associations between preeclampsia and child developmental and behavioural outcomes overall, some associations between preeclampsia-exposure and subtle behavioural issues did persist. Further research is needed to replicate these findings, and determine the clinical significance of changes in SDQ scores.
利用爱尔兰全国代表性儿童研究的数据，检查子痫前期与纵向儿童发育和行为结果之间的关联。
我们使用了爱尔兰儿童纵向研究中母亲报告的数据。子痫前期和子痫前期+小胎龄儿（SGA）的数据是在儿童 9 个月大时收集的。儿童发育和行为结果的数据是在 9 个月时使用年龄和阶段问卷（ASQ）收集的，在 3 岁、5 岁和 7-8 岁时使用困难问卷（SDQ）收集的。使用多变量逻辑回归分析检查子痫前期暴露与 ASQ 域失败和异常 SDQ 域之间的关联。使用线性样条多层模型检查子痫前期与子痫前期+SGA 和 SDQ 重复测量之间的关联。所有模型都控制了几个围产期和社会人口因素。
共有 10692 名儿童在基线时纳入研究，代表了 70791 名儿童的加权总数。多变量逻辑回归表明，子痫前期与任何 ASQ 域失败无关。子痫前期仅与 5 岁时 SDQ 情绪（≥5）和多动（≥7）域的异常截断值相关。在线性样条模型中，暴露组在每个时间点的 SDQ 评分都更高。
虽然我们没有发现子痫前期与儿童发育和行为结果之间存在强烈关联的有力证据，但子痫前期暴露与一些微妙的行为问题之间仍存在一些关联。需要进一步研究来复制这些发现，并确定 SDQ 评分变化的临床意义。
