Hypertensive Disorders of Pregnancy & Brain Development

Question 1

What is an example of a hypertensive disorder associated with pregnancy?

Answer 1

Pre eclampsia (PE)

Question 2

What does PE involve?

Answer 2

• Involves BP rising during pregnancy even though it wasn’t there pre pregnancy
• This is the main feature of it, however there is also a lot going on physiologically

Question 3

What is the strongest risk factor of PE?

Answer 3

The strongest risk factor is having already had PE in a previous pregnancy

Question 4

How does PE typically present?

Answer 4

Onset of chronic hypertension on or after week 20 gestation
Most commonly occurs with proteinuria
Placental insufficiency, endothelial dysfunction, systemic inflammation and organ damage

Question 5

Treatment of PE

Answer 5

There is no effective treatment of PE
→ as of now the main management includes delaying delivery of baby and the placenta: - the main thing that is wrong in PE is that there is faulty and stressed placenta which is sending stress signals throughout the body in both the maternal and fetal side which is perpetuating the disorder.

Question 6

What is the problem with this maternal disorder?

Answer 6

It is not only a maternal disorder - it also affects the fetal brain
- If a mother experiences PE in pregnancy there is roughly a 30-35% increased chance of their child being diagnosed with a neurodevelopmental disorder
- This is especially strong with autism spectrum disorder, ADHD, intellectual disability
- It affects the development of most systems and kids are more likely to have inflammatory disorders, allergies, cardiovascular defects etc.
(Supported by neuroimaging studies)

Question 7

PE research at the moment: - the biggest question in relation to neurodevelopmental disorders?

Answer 7

Is this association real? Are there other things masking it making it seem like there is an association but there’s not?
→ i.e., genetics?