Hypertensive diseases of pregnancy and the development of behavioral problems in childhood and adolescence: the Western Australian Pregnancy Cohort Study.
OBJECTIVE
To examine whether maternal gestational hypertension and preeclampsia are associated with behavioral problems in offspring throughout childhood and early adolescence.


METHODS
We conducted a prospective cohort study of 2804 women in the Western Australian Pregnancy Cohort Study and their children observed at age 2, 5, 8, 10, and 14 years. The Child Behavior Checklist (CBCL) was used to measure problem child behavior with continuous z-scores and clinical cutoff points. Control variables included known biomedical, sociodemographic, and psychological factors.


RESULTS
After adjustment, with general linear model analyses children of women with gestational hypertension were shown to be more likely to have higher CBCL z-scores, indicative of poorer behavior, from 8 years on, with the largest difference seen at 14 years. Children of mothers with preeclampsia were more likely to have lower CBCL z-scores, indicative of pro-social behaviors. The multivariable logistic regression analysis showed that gestational hypertension was predictive of clinically significant CBCL T-scores from age 8 to 14 years. This association was significant for externalizing behavior, such as delinquent and aggressive behavior, and for internalizing behavior at age 14 years. Unexpectedly, preeclampsia reduced internalizing morbidity at ages 5 and 8 years.


CONCLUSIONS
The opposing effect on child and adolescent behavior of gestational hypertension and preeclampsia warrants further attention.
Robinson
Monique
M
Telethon Institute for Child Health Research, Centre for Child Health Research, The University of Western Australia, Perth, Australia. moniquer@ichr.uwa.edu.au
Mattes
Eugen
E
Oddy
Wendy H
WH
de Klerk
Nicholas H
NH
Li
Jianghong
J
McLean
Neil J
NJ
Silburn
Sven R
SR
Zubrick
Stephen R
SR
Stanley
Fiona J
FJ
Newnham
John P
JP
D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology*; D000328:Adult; D000374:Aggression; D001315:Australia / Q000453:epidemiology; D002648:Child; D002653:Child Behavior Disorders / Q000453:epidemiology* / Q000523:psychology*; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D046110:Hypertension, Pregnancy-Induced / Q000453:epidemiology*; D007389:Internal-External Control; D008297:Male; D015999:Multivariate Analysis; D011247:Pregnancy; D011446:Prospective Studies