Maternal hypertensive disorders during pregnancy and the trajectories of offspring emotional and behavioral problems: the ALSPAC birth cohort study

Abstract

Purpose: This study examined the effect of hypertensive disorders during pregnancy on trajectories of emotional and behavioral problems in offspring.

Methods: We used data from the Avon Longitudinal Study of Parents and Children, a prospective birth cohort study in Avon, United Kingdom. A group-based trajectory modeling was used to identify the distinct trajectories of emotional and behavioral problems in children at four time points: at age 3.5, 6.75, 9, and 11 years. Multinomial logistic regression analyses were used to examine the association between hypertensive disorders during pregnancy and trajectories of emotional and behavioral problems.

Results: We identified four trajectories of offspring emotional and behavioral problems: normal (42.6%), borderline decreasing (40.6%), borderline stable (10.0%), and persistently elevated (6.8%). We found that children exposed to maternal pre-eclampsia were more likely to be in the persistently elevated symptom trajectory (OR = 2.72; 95% CI: 1.10-6.74) than in the normal trajectory group. We found no associations between maternal gestational hypertension and trajectories of offspring emotional and behavioral problems.

Conclusions: Maternal pre-eclampsia, but not gestational hypertension was associated with persistently elevated trajectory of offspring emotional and behavioral problems. Our findings highlight that the antenatal environment is important for children's behavioral and emotional development.

Keywords: ALSPAC; Behavioral problems; Emotional problems; Gestational hypertension; Pre-eclampsia.