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December 31, 2025
2 min read
Key takeaways:
- Early-onset preeclampsia was linked to delayed development of problem-solving skills in preterm children.
- No other domains of child development appeared to be affected.
Early-onset preeclampsia was associated with increased risk for delayed early-childhood development in the domain of problem-solving among preterm children, researchers reported.
Although other domains of child development were affected by hypertensive disorders of pregnancy (HDP) and its subtypes, the relationships were not statistically significant, according to data published in JAMA Network Open.
Early-onset preeclampsia was linked to delayed development of problem-solving skills in preterm children. Image: Adobe Stock
Geng Chen, MMSc, of the Graduate School of Medicine at Tohoku University in Sendai, Japan, and colleagues evaluated the association of HDP and developmental patterns in children using data from the Tohoku Medical Megabank Project Birth and prospective Three-Generation Cohort Study, both in Japan.
“HDP are the most common complications of pregnancy, with a global prevalence of 116.4 per 100,000 women of childbearing age. HDP are associated with increased risks of mortality and morbidities in the offspring, and the risks vary among HDP subtypes. Among these subtypes, preeclampsia, one of the most severe complications of pregnancy, is associated with an increased risk of neurodevelopmental delay, as well as cardiovascular and metabolic diseases later in life,” the researchers wrote. “Child development is a dynamic process spanning from infancy to adulthood. It involves aspects of motor skills, speech and language, social, and performance and cognition. … Given the distinct pathological processes across HDP subtypes, it is plausible that these differences could induce varied patterns among exposed children in their development after birth.”
Among 14,023 mother-child pairs (maternal mean age, 33 years; 48% female children), an algorithm applied to antenatal visit records identified that approximately 10% were exposed to HDP.
Child development scores were evaluated at age 6, 12, 24, 42 and 48 months to evaluate development trajectory across areas of communication, gross motor, fine motor, problem-solving and personal-social.
Development trajectory was stratified into one of three patterns: normal, delayed and catch-up.
Children in the catch-up pattern initially showed signs of delayed development but reached their milestones close to the expected rates by 48 months, whereas children with the delayed pattern had persistent delayed developmental performance.
The researchers reported early-onset preeclampsia was linked to delayed development in problem-solving skills (RR = 2.9; 95% CI, 1.43-5.89; P = .047), but no other development areas were affected (P for communication = .15; P for gross motor = .06; P for fine motor = .11; P for personal-social = .85).
The link between early-onset preeclampsia and delayed development in problem-solving skills was attenuated when preterm birth children were omitted from the data, according to the study.
Moreover, the researchers observed no association between other HDP subtypes, such as gestational hypertension and late-onset preeclampsia.
“In this cohort study, fetal exposure to early-onset preeclampsia was associated with a higher risk of a delay pattern in child development in the problem-solving domain. The findings were modified by preterm birth,” the researchers wrote. “These findings suggest that children exposed to preeclampsia in utero require monitoring in their progression in gross motor and problem-solving function, especially if they were born preterm.”
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