Risk Management and Healthcare Policy (Oct 2020)
Reduced Intellectual Ability in Offspring Born from Preeclamptic Mothers: A Prospective Cohort Study
Abstract
Linli Liu,1 Zhou Lin,1 Beihong Zheng,2 Lanlan Wang,1 Jianqin Zou,1 Sanshan Wu,1 Zhongqing Jiang,1 Qiong Jin,1 Xuedan Lai,1 Peihong Lin1 1Department of Gynecology and Obstetrics, Fuzhou First Hospital Affiliated to Fujian Medical University, Fuzhou 350004, People’s Republic of China; 2Center for Assisted Reproductive Technology, Fujian Provincial Maternity and Children’s Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou 350004, People’s Republic of ChinaCorrespondence: Linli LiuDepartment of Gynecology and Obstetrics, Fuzhou First Hospital Affiliated to Fujian Medical University, Fuzhou City, Fujian Province 350004, People’s Republic of ChinaTel/Fax +86-591-88301693Email [email protected]: Severe preeclampsia may affect placental development, and high homocysteine (Hcy) levels are linked to intellectual disability. However, the correlation between perinatal Hcy levels and intellectual ability remains unknown in severe preeclampsia-affected offspring.Objective: We aimed to investigate the intellectual ability in offspring born from preeclamptic mothers and examine the role of prenatal Hcy in the prediction of intellectual disability in preschool-aged offspring.Methods: The IQ scores were compared between 101 children born to mothers with severe preeclampsia and 202 offsprings born to normotensive mothers. Maternal Hcy levels within 7 days prior to delivery and postnatal cord blood Hcy were measured. The associations of Hcy with IQ scores were evaluated, and the optimal cut-off values for predicting intellectual disability in the offspring were estimated.Results: The children born to mothers with severe preeclampsia had a greater postnatal cord blood Hcy than those born from normotensive mothers (P < 0.001), and the mothers with severe preeclampsia presented a higher prenatal Hcy (P < 0.001). The children born to mothers with severe preeclampsia had significantly lower IQ scores than those born from normotensive mothers, and a higher Hcy was associated with a lower IQ in preeclampsia-affected offspring. The prevalence of intellectual disability was 2.86 times higher in severe preeclampsia-affected offspring than in children born from normotensive mothers, and the prevalence of low IQ was greater in children born to mothers with severe preeclampsia than in those from normotensive mothers. ROC curve analysis showed that both maternal and cord blood Hcy were predictors of intellectual disability, and the optimal cut-off for predicting intellectual disability was 17.7 and 9.75 μmol/L for maternal and cord blood Hcy.Conclusion: Perinatal exposure to severe preeclampsia has an adverse effect on postnatal intellectual development, and high maternal and cord blood Hcy may contribute to this association.Keywords: preeclampsia, homocysteine, intellectual ability, ROC curve analysis
