Blood pressure change patterns during pregnancy and neurodevelopment trajectories in early childhood: A birth cohort study.

Background: The impact of maternal blood pressure (BP) changes during pregnancy on offspring's neurodevelopment has been understudied. We investigated the associations between maternal BP change patterns and neurodevelopmental trajectories in children.

Methods: We included 2084 mother-child pairs from an ongoing birth cohort study launched in 2018 in Shenzhen, China. Maternal BPs were repeatedly measured over pregnancy, and children's neurodevelopment status was evaluated regularly within 2 years after birth. We identified BP and neurodevelopmental trajectories using trajectory modeling, followed by multinomial logistic and robust Poisson regressions to estimate associations, adjusting for multiple confounders.

Results: We identified three distinct maternal BP change patterns ("Moderate-stable", "Low-increasing" and "High-decreasing") and three trajectories for global neurodevelopment in children ("High", "Moderate" and "Low"). Compared with children whose mothers in the "Moderate-stable" group, those with mothers in the "High-decreasing" group were more likely to have slower neurodevelopment [adjusted odds ratio (aOR): 1.397 (95 % CI: 0.998-1.957) for "Low" vs "Moderate"; 1.593 (95 % CI: 1.068-2.375) for "Low" vs "High"]. Children with mothers in the "Low-increasing" group also had increased risks of delayed neurodevelopment [aOR: 1.357 (95 % CI: 1.014-1.818) for "Low" vs "Moderate"; 1.416 (95 % CI: 1.005-1.994) for "Low" vs "High"]. Consistent results were found in domain-specific analyses as children whose mothers had "Moderate-stable" BP change patterns generally had better neurodevelopment.

Conclusions: We found that a moderate and stable maternal BP during pregnancy was associated with better neurodevelopment in offspring.