New Delhi: Hypertension is a common complication seen in pregnancy and a leading cause of maternal and foetal morbidity.
Hypertensive disorders of pregnancy (HDPs) include chronic hypertension, gestational hypertension, pre-eclampsia (de novo or superimposed on chronic hypertension) and white coat hypertension.
HDP’s create a hostile environment in the uterus as a result of multiple pathophysiological changes including reduced placental blood flow, maternal inflammation, and oxidative stress.
“These changes can potentially alter foetal development, which may increase the risk of long-term vascular, cognitive and psychiatric complications in the newborn child. HDP has been linked to an increased risk of neurodevelopmental disorders including ASD (autism spectrum disorder) and ADHD (Attention-deficit/hyperactivity disorder), ” said Dr. Alka Gupta, Senior Consultant, Obstetrics and Gynaecology, La Femme, Shalimar Bagh.
The signs of autism spectrum disorder include problems in 2 key areas – social interaction and social communication and limited interests.
ADHD, on the other hand, has symptoms like increased activity, also called hyperactivity, poor decision-making and trouble in paying attention.
There is a growing consensus that early identification and intervention are key to improving long-term neurodevelopmental outcomes.
“Previously published work has indicated that early behavioral intervention, if commenced before 30 months, can lead to improvements in cognitive and adaptive behavior among individuals with ASD. Despite this increasing recognition for surveillance, the average age of ASD diagnosis is approximately 4-5 years, meaning the window for intervention has closed.
However, research suggests that a stable diagnosis can be made as young as 2 years, allowing earlier access to specialised services, ” said Dr. Nupur Gupta, Senior Consultant, Gynaecology, Paras Hospitals Gurgaon.
This, in turn, could allow for early intervention that may aid the improvement of neurodevelopmental outcome.
According to a recent research paper published in the journal Jama Psychiatry (June 06, 2018) children born to mothers exposed to hypertensive disorders of pregnancy (HDP) were at increased risk of neurodevelopmental disorders including ASD and ADHD.
The research opens up the potential need for increased developmental screening to allow for early intervention and, in turn, improved neurodevelopmental outcomes.