Summary: New research adds to evidence that chronic, low-grade inflammation during pregnancy is linked to a higher risk of neurodevelopmental delays in children.
Source: Elsevier
Obesity, diabetes, high blood pressure, depression and anxiety during pregnancy are associated with greater odds of learning difficulties, behavioral problems and early mental health concerns in children. A study published in the journal Biological Psychiatry (Elsevier) strengthens the case that persistent, low-grade maternal inflammation common to these conditions may help explain the increased risk of childhood neurodevelopmental delays.
Researchers have long considered maternal inflammation as a possible contributor to altered fetal brain development. Animal studies previously implicated inflammatory processes during pregnancy in offspring neurodevelopmental problems, and this human study provides further clinical evidence supporting that link.
“Our findings point to a possible therapeutic strategy to reduce prenatal exposure to inflammation and improve childhood developmental outcomes,” said Polina Girchenko, PhD, an epidemiologist and postdoctoral researcher at the University of Helsinki’s Department of Psychology and Logopedics and the study’s first author.
The research team analyzed data from 418 mother-child pairs in Southern and Eastern Finland drawn from the PREDO study, which was originally designed to predict and prevent preeclampsia and included many pregnancies with risk factors such as maternal obesity, gestational diabetes and hypertension. The investigators measured two inflammatory biomarkers in maternal blood—high-sensitivity C-reactive protein (hsCRP) and glycoprotein acetyls—at three points during pregnancy. Diagnoses of maternal depression and anxiety were obtained from Finland’s national health register.
Child developmental outcomes were assessed using a combination of medical registry records and mothers’ reports. The study defined developmental delay across cognitive, motor and social domains by pooling clinical diagnoses from the national registry with parent-completed Ages and Stages Questionnaire data on milestones.
Key findings showed that prenatal exposure to at least one maternal metabolic condition (overweight/obesity, diabetes, hypertensive disorders) or a maternal mood/anxiety disorder roughly doubled the likelihood that a child would have delays across multiple neurodevelopmental areas. Those exposures were also linked to persistently elevated antenatal inflammation. Higher prenatal levels of both measured inflammatory biomarkers were associated with increased risk of neurodevelopmental delay in children, and the combination of the two biomarkers predicted risk more reliably than either marker alone.
“This study highlights that some potentially modifiable prenatal factors may increase the negative impact of adverse environments upon brain and behavior during childhood,” said John Krystal, MD, Editor of Biological Psychiatry.
Dr. Girchenko emphasized the potential for prevention: “For women who are at risk, antenatal interventions aimed at lowering inflammation—such as dietary changes or supplements linked to reduced inflammatory markers—could offer targeted prevention. Future trials are needed to identify which interventions are most effective.”
The investigators note that intervention trials will be essential to determine how different prenatal strategies affect both maternal inflammation and child developmental outcomes. The study also raises additional questions about how specific maternal conditions relate to particular types of childhood difficulties, and it encourages further research to develop and test interventions that promote healthier neurodevelopmental trajectories from the start of life.
Source:
Elsevier
Media Contacts:
Rhiannon Bugno – Elsevier
Image Source:
The image is in the public domain.
Original Research: Closed access
“Persistently High Levels of Maternal Antenatal Inflammation Are Associated With and Mediate the Effect of Prenatal Environmental Adversities on Neurodevelopmental Delay in the Offspring”. Polina Girchenko, PhD, Marius Lahti-Pulkkinen, PhD, Kati Heinonen, PhD, Rebecca M. Reynolds, MD, PhD, Hannele Laivuori, MD, PhD, Jari Lipsanen, MA, Pia M. Villa, MD, PhD, Esa Hämäläinen, MD, PhD, Eero Kajantie, MD, PhD, Jari Lahti, PhD, Katri Räikkönen, PhD.
Biological Psychiatry doi:10.1016/j.biopsych.2019.12.004.
Abstract
Persistently High Levels of Maternal Antenatal Inflammation Are Associated With and Mediate the Effect of Prenatal Environmental Adversities on Neurodevelopmental Delay in the Offspring
Background
Prenatal exposure to environmental adversities—maternal overweight/obesity, diabetes or hypertensive disorders, and mood or anxiety disorders—increases the risk of adverse neurodevelopmental outcomes in children. The biological pathways remain unclear. This study examined whether maternal antenatal inflammation relates to the number of neurodevelopmental delay areas in children and whether it mediates the relationship between prenatal environmental adversities and those delays.
Methods
We followed 418 mother-child dyads from the PREDO study up to 10.8 years. Maternal plasma hsCRP and glycoprotein acetyls were measured at three antenatal time points. Early-pregnancy BMI was recorded, and pregnancy diabetes and hypertensive disorders were obtained from medical records. Mood and anxiety disorder data were sourced from the Care Register for Health Care. Child neurodevelopmental delay was estimated across cognitive, motor, and social domains by combining clinical registry data on psychological development disorders with mother-reported Ages and Stages Questionnaire milestone data.
Results
Elevated maternal hsCRP and glycoprotein acetyls at individual and across all three antenatal time points were associated with a 1.30- to 2.36-fold increased relative risk for a higher number of child neurodevelopmental delay areas (p < .02). Persistent maternal inflammation across pregnancy also mediated the impact of prenatal environmental adversity on child neurodevelopmental delay.
Conclusions
Higher maternal inflammation—particularly when sustained throughout pregnancy—raises a child’s risk for neurodevelopmental delays and helps explain how prenatal environmental adversities affect early development.