title: Prospective assessment of neurodevelopment in children following a pregnancy complicated by severe pre-eclampsia.
abstract: To prospectively examine whether children of women with a pregnancy affected by severe pre-eclampsia (PE), compared to children of women without a PE-affected pregnancy, have differences in neurodevelopmental performance up to 5 years of age.
  
  
  
  Prospective cohort study.
  
  
  
  Tertiary care centre.
  
  
  
  Women were recruited following a PE-affected pregnancy. After each PE participant was recruited, the next normotensive woman without a prior history of PE and matched by parity, maternal age and race was invited to participate. Women with a history of chronic hypertension, diabetes or renal disease were excluded. Total enrolment included 129 PE-affected and 140 normotensive mothers.
  
  
  
  The primary outcome measure was failure of the Ages and Stages Questionnaire (ASQ). The ASQ was completed yearly, until age 5.
  
  
  
  A significant difference was found in the proportion of ASQ categories failed in year 3 (p<0.05), and this approached significance in years 1 and 4 (p<0.10 and p<0.15, respectively). At year 1, the number of ASQ categories failed was significantly greater among children born to PE mothers. A subgroup analysis revealed that a significant proportion of PE children born preterm (<37 weeks) failed the ASQ in years 3 and 4 (p<0.05), and when failed, those who were preterm failed significantly more categories (p<0.05). A trend towards increased failure in the gross motor category was found. There was a significant positive correlation between maternal lifetime CVD risk score and number of ASQ categories failed at years 1 and 3 (p<0.05).
  
  
  
  Severe PE is associated with other adverse pregnancy outcomes, including intrauterine growth restriction and preterm birth, all of which are associated with increased neurodevelopment delays. Thus, PE indicates a need for early screening and intervention at the neurodevelopmental level to improve children's long-term health, with larger studies required to tease out contributing factors.
authors.affiliation: Department of Obstetrics and Gynecology, Kingston General Hospital, Queen's University, Kingston, Ontario, Canada.
authors.forename: Chelsie
authors.initials: C
authors.lastname: Warshafsky
authors.affiliation: Department of Obstetrics and Gynecology, Kingston General Hospital, Queen's University, Kingston, Ontario, Canada.
authors.forename: Jessica
authors.identifier: 0000-0002-7000-2605
authors.initials: J
authors.lastname: Pudwell
authors.affiliation: Department of Obstetrics and Gynecology, Ottawa Health Research Institute, University of Ottawa, Ottawa, Ontario, Canada.
authors.forename: Mark
authors.initials: M
authors.lastname: Walker
authors.affiliation: Department of Obstetrics and Gynecology, Ottawa Health Research Institute, University of Ottawa, Ottawa, Ontario, Canada.
authors.forename: Shi-Wu
authors.initials: SW
authors.lastname: Wen
authors.affiliation: Department of Obstetrics and Gynecology, Kingston General Hospital, Queen's University, Kingston, Ontario, Canada Department of Biomedical and Molecular Sciences, Kingston General Hospital, Queen's University, Kingston, Ontario, Canada.
authors.forename: Graeme N
authors.initials: GN
authors.lastname: Smith
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008137:Longitudinal Studies; D008297:Male; D065886:Neurodevelopmental Disorders / Q000453:epidemiology*; D009864:Ontario / Q000453:epidemiology; D011225:Pre-Eclampsia / Q000453:epidemiology*; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects / Q000453:epidemiology*; D011446:Prospective Studies; D012720:Severity of Illness Index
keywords: NEONATOLOGY; OBSTETRICS; PREVENTIVE MEDICINE