University of Oulu

Lahti-Pulkkinen, M., Girchenko, P., Tuovinen, S., Sammallahti, S., Reynolds, R., Lahti, J., Heinonen, K., Lipsanen, J., Hämäläinen, E., Villa, P., Kajantie, E., Laivuori, H., Räikkönen, K. (2020) Maternal Hypertensive Pregnancy Disorders and Mental Disorders in Children. Hypertension, 75 (6), 1429-1438.

Maternal hypertensive pregnancy disorders and mental disorders in children

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Author: Lahti-Pulkkinen, Marius1,2,3; Girchenko, Polina1; Tuovinen, Soile1;
Organizations: 1University of Helsinki, Finland
2National Institute for Health and Welfare, Helsinki, Finland
3University of Edinburgh, United Kingdom
4Erasmus Medical Center, Rotterdam, the Netherlands
5University of Turku, Finland
6University of Helsinki and Helsinki University Hospital, Finland
7Hyvinkää Hospital, Finland
8Oulu University Hospital and University of Oulu, Finland
9Norwegian University for Science and Technology, Trondheim, Norway
10University of Tampere, Finland
Format: article
Version: accepted version
Access: open
Online Access: PDF Full Text (PDF, 0.8 MB)
Persistent link:
Language: English
Published: Wolters Kluwer, 2020
Publish Date: 2020-10-20


The associations of maternal hypertensive pregnancy disorders with offspring mental disorders remain unclear. We examined whether maternal hypertensive disorders and maximum blood pressure during pregnancy predict offspring childhood mental disorders, whether the associations are independent of maternal and paternal mental disorders and paternal hypertensive disorders, independent of or additive with maternal early pregnancy overweight/obesity and diabetes mellitus disorders, and mediated or moderated by preterm birth, small-for-gestational-age birth and neonatal intensive care unit admission. Our prospective study comprised 4743 mother-child dyads of Prediction and Prevention of Preeclampsia and Intrauterine Growth Restriction study. Women were recruited to the study in early pregnancy at Finnish maternity hospitals. Children were born 2006 to 2010 and followed-up until December 31, 2016, to ages 6.4 to 10.8 years. Hypertensive pregnancy disorders were identified from medical records, Medical Birth Register, and Care Register for Health Care. Systolic and diastolic blood pressure were measured at antenatal clinics and hospital visits. Mental disorder diagnoses were identified from Care Register for Health Care. Maternal gestational and chronic hypertension, preeclampsia and its severity increased offspring hazard of any childhood mental disorder. The associations of preeclampsia (hazard ratio=1.66 [95% CI, 1.14–2.42]) and severe preeclampsia (hazard ratio=2.01 [95% CI, 1.08–3.73]) were independent of all covariates. Maternal hypertensive and diabetes mellitus disorders and overweight/obesity also additively increased offspring hazard of mental disorders. Preterm and small-for-gestational-age births and neonatal intensive care unit admission partially mediated the effects of any and severe preeclampsia on offspring mental disorders. To conclude, maternal hypertensive pregnancy disorders carry adverse consequences for offspring mental health.

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Series: Hypertension
ISSN: 0194-911X
ISSN-E: 1524-4563
ISSN-L: 0194-911X
Volume: 75
Issue: 6
Pages: 1429 - 1438
DOI: 10.1161/HYPERTENSIONAHA.119.14140
Type of Publication: A1 Journal article – refereed
Field of Science: 3123 Gynaecology and paediatrics
Funding: This study was supported by Academy of Finland, European Union’s Horizon 2020 Award SC1-2016-RTD-733280 for Research on European Children and Adults Born Preterm (RECAP), European Commission Dynamics of Inequality Across the Life-course: structures and processes (DIAL) No 724363 for PremLife, Erityisvaltionosuus (EVO) (special state subsidy for research), University of Helsinki Funds, Signe and Ane Gyllenberg Foundation, Orion Research Foundation, Emil Aaltonen Foundation, Finnish Medical Foundation, Jane and Aatos Erkko Foundation, Novo Nordisk Foundation, Päivikki and Sakari Sohlberg Foundation, Sigrid Juselius Foundation and Sir Jules Thorn Charitable Trust.
Copyright information: © 2020 American Heart Association, Inc. The final authenticated version is available online at