Relationship between preeclampsia and developmental delay?

A: Some studies indicate a link to autism as well as low birth weight and premature birth.

Most women and men have a limited understanding of preeclampsia and its danger to both mother and baby. Preeclampsia is one form of a high blood pressure disorder of pregnancy that typically manifests in the third trimester. High blood pressure disorders are among the most common medical disorders of pregnancy, occurring in up to 12-22% of pregnant women. Preeclampsia is one of the leading contributors to premature birth, maternal complications and can have serious short and long-term ramifications for both mother and baby. The best way to manage preeclampsia is to catch it early on!

What are some of the risk factors for preeclampsia?

Being diabetic, over the age of 40, obese and being pregnant with multiple babies are all risk factors for preeclampsia. However, any pregnant woman can develop preeclampsia. In fact, women who did not have preeclampsia during pregnancy can still develop it during the postpartum period, up to six weeks after giving birth.

What are the symptoms of preeclampsia?
The symptoms of preeclampsia include swelling, sudden weight gain, stomach pain, lower back pain, nausea or vomiting, headaches and changes in vision. Pregnant women and new moms should not disregard symptoms since they may not know what they “should” be feeling during pregnancy or postpartum. Family members are key partners in preventing maternal complications and deaths by stepping in when their spouse or partner complains of a relentless headache, difficulty breathing, and other concerning symptoms. Contact your Obstetrician right away.

What is the correlation between preeclampsia and autism?

A recent study published in JAMA Pediatrics found that “increasing evidence suggests that autism spectrum disorder (ASD) and many forms of developmental delay (DD) originate during fetal development. Preeclampsia may trigger aberrant neurodevelopment through placental, maternal, and fetal physiologic mechanisms. “

The study found that children born to mothers who had preeclampsia during pregnancy are more than twice as likely to develop autism spectrum disorder. The foundation for possible preeclampsia later in pregnancy starts with the altered way the placenta attaches into the uterus, leading to decreased blood flow to the placenta, and secondarily to the baby. When high blood pressure or full blown preeclampsia develops, the reduced blood flow can limit the supply of oxygen and nutrients which goes to the baby.

Preeclampsia also increases a baby’s risk for low birth weight and premature birth, which are factors that have also been found to increase a child’s risk for autism. The more severe forms of preeclampsia were associated with increased risk of autism in the baby. Very reduced placental blood flow (insufficiency) to the baby was associated with a five-fold risk for developmental delay.

What should I do if I have preeclampsia?
Current recommendations call for close follow-up of women with elevated blood pressures or preeclampsia even after delivery. Women who have experienced preeclampsia need to see their OB GYN within one week of delivery. Women should be encouraged to monitor their blood pressure at home with instructions to call their physician if their pressures reach or exceed 140/90 or if they have symptoms of high blood pressure or preeclampsia.

Where can I learn more?
Expectant mothers or those who recently had a baby should consult their OB GYN or physician anesthesiologist if they have questions about preeclampsia. The Preeclampsia Foundation has additional patient education materials on its website.

Mark Zakowski, M.D. is a Chief of Obstetric Anesthesiology at Cedars-Sinai Medical Center in Los Angeles. He advocates for women’s health within the medical community by serving on the Board of Directors for the California Society of Anesthesiologists, the national Society of Obstetric Anesthesiology and Perinatology and the Task Force on Preeclampsia CMQCC, developing guidelines for preeclampsia recognition and management in order to reduce maternal deaths and neonatal morbidity. He even wrote a book to help pregnant couples, C-Section: how to avoid, prepare for and recover from your cesarean. More information about Dr. Zakowski’s work is available at www.DrMarkZakowski.com