Preeclampsia and academic performance in children: A nationwide study from Iceland

Hypertensive disorders complicate up to 10% of pregnancies. Evidence suggests a potential association between maternal hypertensive disorders during pregnancy, particularly preeclampsia, and adverse neurodevelopment in the offspring, but existing studies are subject to limitations. We aimed to asses...

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Bibliographic Details
Published in:PloS one Vol. 13; no. 11; p. e0207884
Main Authors: Sverrisson, Fridgeir A., Bateman, Brian T., Aspelund, Thor, Skulason, Sigurgrimur, Zoega, Helga
Format: Journal Article
Language:English
Published: United States Public Library of Science 21.11.2018
Public Library of Science (PLoS)
Subjects:
Academic achievement
Age
Biology and Life Sciences
Children
Children & youth
Data analysis
Disorders
Eclampsia
Education
Exposure
Health sciences
Hypertension
Intrauterine exposure
Language arts
Mathematics
Medicine
Medicine and Health Sciences
Offspring
Pediatrics
People and Places
Population
Pre-eclampsia
Preeclampsia
Pregnancy
Public health
Social Sciences
Standard deviation
Standardized tests
Studies
New York
United States > US
Massachusetts
Iceland
ISSN:1932-6203, 1932-6203
Online Access:Get full text
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Summary:Hypertensive disorders complicate up to 10% of pregnancies. Evidence suggests a potential association between maternal hypertensive disorders during pregnancy, particularly preeclampsia, and adverse neurodevelopment in the offspring, but existing studies are subject to limitations. We aimed to assess whether in-utero exposure to preeclampsia/eclampsia negatively impacts academic performance at ages 9, 12 and 15 years. Using individually linked, nationwide data from the Icelandic registries we followed all children born in 1989-2004 (N = 68,580), from birth until the end of 2014, thereof 63,014 (91.9%) took at least one standardized test. Using a stepwise, mixed-effects approach, we modelled the hypothesized relationship while adjusting for maternal, perinatal and childhood variables of interest. We compared test scores, measured on a normalized scale ranging from 0-60 with a mean of 30 and a standard deviation of 10, in the 4th, 7th, and 10th grades, between children exposed to preeclampsia or eclampsia in-utero versus children from normotensive pregnancies in the population. Children exposed to preeclampsia/eclampsia scored lower than those unexposed in mathematics across all grade levels, corresponding to a difference of 0.44 points (95% CI: 0.00, 0.89), 0.59 points (95% CI: 0.13, 1.06) and 0.59 points (95% CI: 0.08, 1.10), respectively. No differences were observed in the language arts. Our findings suggest a minimal effect of maternal preeclampsia/eclampsia on children's academic performance at ages 9, 12 and 15 years. The differences observed in mathematic scores between exposed and unexposed children were minimal, less than one tenth of a standard deviation per measurement occasion.
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Competing Interests: Dr. Bateman is an investigator on grants to the Brigham and Women’s Hospital from Lilly, Pfizer, GSK, Pacira, and Baxalta for projects unrelated to the topic of this manuscript. Dr. Bateman consults for Optum on unrelated projects. The other authors have no financial relationships relevant to this article and no conflicts of interest to disclose. This does not alter our adherence to PLOS ONE policies on sharing data and materials.
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0207884