Hypertensive pregnancies linked to mental health disorder risk in offspring
MedWire News: Individuals born to women who experienced hypertension without proteinuria during pregnancy are at increased risk for mental health disorders, results from a Finnish study suggest.
Soile Tuovinen (University of Helsinki) and team explain: "Growing empirical evidence suggests that a suboptimal prenatal environment, reflected in smaller body size at birth and/or shorter length of gestation, associates with the risk of any mental disorder, and specific disorders including schizophrenia, personality disorder, mood disorder, and substance use disorder in later life."
However, they add that "studies testing if hypertensive disorders in pregnancy are associated with mental disorders in the offspring are scarce and the findings are controversial."
To investigate further, the team studied data on 5970 individuals from the Helsinki Birth Cohort Study who were born between 1934 and 1944 after normotensive (n=3963), hypertensive (n=1733), or pre-eclamptic (n=274) pregnancies.
The Finnish Hospital Discharge Register and Finnish Causes of Death Register were used to identify all participants with mental disorders severe enough to warrant or contribute to hospital treatment or death.
After accounting for factors such as gender, year of birth, gestational age, weight at birth, and mother's age and body mass index at delivery, the researchers found that the risk for any severe mental health disorder was significantly higher among individuals born after pregnancies complicated by hypertension without proteinuria than among those born after normotensive pregnancies, at a hazard ratio (HR) of 1.19.
The significantly increased risk for severe mental health disorders associated with pregnancies complicated by hypertension without proteinuria was particularly elevated for mood and anxiety disorders, at adjusted HRs of 1.44 and 1.39, respectively.
Individuals born after pregnancies complicated by hypertension without proteinuria were also at a nonsignificant 1.38-fold increased risk for psychotic disorders compared with those born after normotensive pregnancies.
By contrast, male participants born after pre-eclamptic (hypertension with proteinuria) pregnancies were 25% less likely to develop a mental health disorder than individuals born after normotensive pregnancies.
The researchers summarize in the Journal of Psychiatric Research: "We found that hypertension without proteinuria in pregnancy was associated with a higher risk of any mental disorder and of mood disorders requiring hospitalization or contributing to death in the offspring in adulthood. Preeclampsia was, in turn, associated with a lower risk of any mental disorder in the male offspring."
They add: "While our findings may hint at mechanisms by which prenatal adversity associates with mental disorders in subsequent life, the exact mechanisms linking hypertension without proteinuria in pregnancy with higher risk of mental disorders in subsequent life remain to be determined."
By Mark Cowen