title: Pre-eclampsia- an additional risk factor for cognitive impairment at school age after intrauterine growth restriction and very preterm birth.
abstract: OBJECTIVE
  To explore the possible influence of pre-eclampsia on cognitive outcome in children born very preterm after intrauterine growth restriction (IUGR) and abnormal umbilical artery blood flow.
  
  
  METHODS
  Cognitive function was evaluated at 5-8 years of age with Wechsler scales in 34 children born before 30 gestational weeks after IUGR (PT-IUGR) (11 children were exposed to maternal pre-eclampsia, 23 non-exposed) and in 34 children with no maternal pre-eclampsia and birth weight appropriate-for-gestational age (PT-AGA) matched for gestational age at birth, gender and age at examination.
  
  
  RESULTS
  The subjects in the PT-IUGR group exposed to maternal pre-eclampsia had lower mean verbal IQ (VIQ) (mean ± SD 74 ± 16) and lower full scale IQ (FSIQ) (70 ± 19) in comparison with both the non-exposed PT-IUGR (VIQ 89 ± 15; p=0.013; FSIQ 83 ± 14, p=0.029), and, the PT-AGA group (VIQ 96 ± 15, p<0.001; FSIQ 90 ± 14, p=0.001). The differences remained significant after adjustment for known confounders. VIQ and FSIQ did not differ between the non-exposed IUGR and PT-AGA children.
  
  
  CONCLUSIONS
  Fetal exposure to maternal pre-eclampsia seems to have an additional negative impact to that of IUGR on cognitive function in children born very preterm.
authors.affiliation: Department of Pediatrics, Clinical Sciences Lund, Lund University, Lund, Sweden. Electronic address: eva.morsing@med.lu.se.
authors.forename: E
authors.initials: E
authors.lastname: Morsing
authors.affiliation: Departments of Obstetrics and Gynecology, Clinical Sciences Lund, Lund University, Lund, Sweden.
authors.forename: K
authors.initials: K
authors.lastname: Maršál
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D002648:Child; D005260:Female; D005317:Fetal Growth Retardation / Q000503:physiopathology*; D006801:Humans; D062071:Infant, Extremely Premature / Q000254:growth & development*; D007231:Infant, Newborn; D008607:Intellectual Disability / Q000175:diagnosis / Q000209:etiology*; D008297:Male; D011225:Pre-Eclampsia / Q000503:physiopathology*; D011247:Pregnancy; D012307:Risk Factors; D014888:Wechsler Scales
keywords: Cognitive outcome; Intrauterine growth restriction; Pre-eclampsia; Umbilical blood flow; Very preterm birth