Preeclampsia: Effect on Offspring Neurological Development

Preeclampsia is a complication that occurs in roughly 3-5% of pregnancies, and when left untreated can lead to eclampsia, the number one cause of maternal and fetal mortality. Preeclampsia is characterized by hypertension (increased blood pressure), proteinuria (increased amount of protein in the mother’s urine and edema (a buildup of fluid in the skin). Preeclampsia (PE) can be caused by a number of factors including genetic predispositions, obesity, maternal health and vascular disease while most often occurring in a first term pregnancy. Al-Jameil. “A Brief Overview of Preeclampsia.” Journal of Clinical Medicine Research, 2013, www.ncbi.nlm.nih.gov/pmc/articles/PMC3881982/, https://doi.org/10.4021/jocmr1682. 

The believed cause of PE is due to disrupted vascular development in the placenta. This Results in anti-angiogenic factors or the inability of new blood vessels to develop, and microangiopathy, the disease of the small blood vessels in the placenta. This results in the placenta not obtaining adequate blood perfusion, resulting in the fetus not getting optimal oxygen or nutrients needed for proper growth and neuro development during gestation.

Preeclamptic pregnancies face a lot of risks for mother and baby, including permanent impaired fetal cognitive and neurological development. The presence of anti-angiogenic factors results in a deformed anatomy of the nerves and blood vessels in the baby’s brain. In comparison to offspring born through non preeclamptic pregnancies, PE births result in a different anatomical shape of the brain along with a significant difference in the amount of white matter found, which is vital for communication between various brain regions. In addition, babies born from preeclamptic pregnancies are often born prematurely due to the risk of morbidity or mortality from a full-term pregnancy. This results in the fetus’ brain and body not having time to fully develop inside the womb.

In an article written by Dr. Cheryl K. Walker, she covered a study called The Childhood Autism Risks from Genetics and the Environment (CHARGE). In the study there were children from three groups. One group of children with ASD, another with DD (developmental delay) and the last with TD (typical development). The result of the study confirmed that children with cognitive impairments were significantly more likely to be born from a preeclamptic pregnancy than those of a healthy, full-term pregnancy. Walker, Cheryl K., et al. “Preeclampsia, Placental Insufficiency, and autism spectrum disorder or Developmental Delay.” JAMA Pediatrics, vol. 169, no. 2, 1 Feb. 2015, p. 154, jamanetwork.com/journals/jamapediatrics/fullarticle/2020784, https://doi.org/10.1001/jamapediatrics.2014.2645. The likely cause of this outcome is due to the placenta being restricted from proper profusion, leading to hypoxia in the fetus, negatively impacting its brain’s physical growth and development. 

In an article posted by the American Journal of Neuroradiology, there was a study that compared MRIs of children born from preeclamptic pregnancies in comparison to children born through healthy pregnancy. In the study, it showed that children born in a PE pregnancy showed enlarged brain territory volumes of the cerebellum, temporal lobe, brain stem, and right and left amygdalae. The same children also exhibited a decreased size in their cerebral vessels of the occipital and parietal lobes. The same anatomical differences found in this study for children born in PE, are very similar to the structures of children’s brains who have ASD. In addition, it was also discovered through a test called an enzyme-linked immunosorbent assay, aka ELISA that the amount of placental growth factor was less than that of women without PE compared to a PE pregnancy. Rätsep, M. T., et al. “Brain Structural and Vascular Anatomy Is Altered in Offspring of Pre-Eclamptic Pregnancies: A Pilot Study.” AJNR. American Journal of Neuroradiology, vol. 37, no. 5, 1 May 2016, pp. 939–945, pubmed.ncbi.nlm.nih.gov/26721772/, https://doi.org/10.3174/ajnr.A4640. Accessed 8 May 2022. The placental growth factor is a protein that is a key component in angiogenesis and vasculogenesis during embryonic development, which is an important aspect to ensure the fetus is able to get adequate perfusion. Although more research is still being introduced, there are many indicators that preeclampsia is linked to numerous neurological and cognitive delays.

MLA citations; 

• Walker, Cheryl K., et al. “Preeclampsia, Placental Insufficiency, and Autism Spectrum Disorder or Developmental Delay.” JAMA Pediatrics, vol. 169, no. 2, 1 Feb. 2015, p. 154, jamanetwork.com/journals/jamapediatrics/fullarticle/2020784, https://doi.org/10.1001/jamapediatrics.2014.2645
• Rätsep, M. T., et al. “Brain Structural and Vascular Anatomy Is Altered in Offspring of Pre-Eclamptic Pregnancies: A Pilot Study.” AJNR. American Journal of Neuroradiology, vol. 37, no. 5, 1 May 2016, pp. 939–945, pubmed.ncbi.nlm.nih.gov/26721772/, https://doi.org/10.3174/ajnr.A4640
• Al-Jameil. “A Brief Overview of Preeclampsia.” Journal of Clinical Medicine Research, 2013, www.ncbi.nlm.nih.gov/pmc/articles/PMC3881982/, https://doi.org/10.4021/jocmr1682w.