Neurological function in children born to preeclamptic and hypertensive mothers - A systematic review

Ernesto A Figueiró-Filho; Lauren E Mak; James N Reynolds; Patrick W Stroman; Graeme N Smith; Nils D Forkert; Angelina Paolozza; Matthew T Rätsep; B Anne Croy

doi:10.1016/j.preghy.2017.07.144

Neurological function in children born to preeclamptic and hypertensive mothers - A systematic review

Pregnancy Hypertens. 2017 Oct:10:1-6. doi: 10.1016/j.preghy.2017.07.144. Epub 2017 Jul 25.

Authors

Ernesto A Figueiró-Filho¹, Lauren E Mak², James N Reynolds², Patrick W Stroman³, Graeme N Smith⁴, Nils D Forkert⁵, Angelina Paolozza⁶, Matthew T Rätsep⁷, B Anne Croy⁸

Affiliations

¹ Department of Biomedical and Molecular Sciences, Queen's University, Kingston, ON, Canada; Faculty of Medicine, Federal University of Mato Grosso do Sul, (FAMED-UFMS), Campo Grande, MS, Brazil; Centre for Neuroscience Studies, Queen's University, Kingston, ON, Canada. Electronic address: eaff@queensu.ca.
² Department of Biomedical and Molecular Sciences, Queen's University, Kingston, ON, Canada; Centre for Neuroscience Studies, Queen's University, Kingston, ON, Canada.
³ Centre for Neuroscience Studies, Queen's University, Kingston, ON, Canada.
⁴ Department of Biomedical and Molecular Sciences, Queen's University, Kingston, ON, Canada; Department of Obstetrics and Gynecology, Queen's University, Kingston, ON, Canada.
⁵ Department of Radiology and Hotchkiss Brain Institute, University of Calgary, 3330 Hospital Drive NW, Calgary, AB, Canada.
⁶ Laboratory for Infant Studies, University of Toronto Scarborough, Scarborough, ON, Canada.
⁷ Department of Obstetrics and Gynecology, Queen's University, Kingston, ON, Canada.
⁸ Department of Biomedical and Molecular Sciences, Queen's University, Kingston, ON, Canada.

PMID: 29153658
DOI: 10.1016/j.preghy.2017.07.144

Abstract

Background: Offspring whose mothers developed preeclampsia (PE-F1s) show developmental effects that are now being identified, such as cognitive, behavioural, and mood differences compared to offspring from non-complicated pregnancies. We hypothesize that the progressive angiokine dysregulation associated with development of preeclampsia (PE) reflects gene dysregulation in pre-implantation conceptuses, and manifests in all developing fetal tissues rather than exclusively to the placenta. This hypothesis predicts that fetal cerebrovascular and brain development are deviated by fetal-intrinsic, brain-based mechanisms during what is currently considered a placentally-induced maternal disease. Due to our initial results from brain-imaging and cognitive screening in a child pilot PE-F1 cohort, we developed this systematic review to answer the question of whether any consistent neurological measurements have been found to discriminate between brain functions in offspring of mothers who experienced a hypertensive pregnancy vs. offspring of mothers that did not.

Methods: Relevant studies were searched systematically up to June 2017 in MEDLINE, PsycINFO, EMBASE and the grey literature.

Results: Following predetermined inclusion and exclusion criteria, our search identified 27 out of 464 studies reporting on neurological function in offspring born to preeclamptic and hypertensive mothers.

Conclusion: The current literature strongly supports the conclusion of the behavioural and cognitive deviations in PE-F1s. However, only three studies associated their findings with brain measurements via magnetic resonance imaging (MRI) in both healthy and at-risk pediatric populations. PE-F1s should be identified as an at-risk pediatric population during brain development and studied further as a defined group, perhaps stratified by maternal plasma angiokine levels.

Keywords: Case-control studies; Functional neuroimaging; Human pregnancy; Magnetic resonance imaging.

Publication types

Review
Systematic Review

MeSH terms

Brain / growth & development*
Child
Child of Impaired Parents
Cognition Disorders / etiology
Developmental Disabilities / etiology
Female
Humans
Pre-Eclampsia*
Pregnancy