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October 09, 2012; 79 (15) Articles

Hypertensive disorders in pregnancy and cognitive decline in the offspring up to old age

Soile Tuovinen, Katri Räikkönen, Eero Kajantie, Markus Henriksson, Jukka T. Leskinen, Anu-Katriina Pesonen, Kati Heinonen, Jari Lahti, Riikka Pyhälä, Hanna Alastalo, Marius Lahti, Clive Osmond, David J.P. Barker, Johan G. Eriksson
First published October 3, 2012, DOI: https://doi.org/10.1212/WNL.0b013e31826e2606
Soile Tuovinen
From the Institute of Behavioral Sciences (S.T., K.R., A.-K.P., K.H., J.L., R.P., M.L.), Hospital for Children and Adolescents, Institute of Clinical Medicine (E.K.), and Department of General Practice and Primary Health Care (J.G.E.), University of Helsinki, Helsinki; Department of Chronic Disease Prevention (E.K., H.A., J.G.E.), National Institute for Health and Welfare, Helsinki; Centre for Military Medicine (M.H.), Finnish Defence Forces, Lahti; National Supervisory Authority for Welfare and Health (M.H.), Helsinki; National Defence College (J.T.L.), Finnish Defence Forces, Helsinki, Finland; Medical Research Council Epidemiology Resource Centre (C.O., D.J.P.B.) and Developmental Origins of Health and Disease Centre (D.J.P.B.), University of Southampton, Southampton, UK; Helsinki University Central Hospital (J.G.E.), Unit of General Practice, Helsinki; Folkhälsan Research Centre (J.G.E.), Helsinki; and Vasa Central Hospital (J.G.E.), Vasa, Finland.
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Katri Räikkönen
From the Institute of Behavioral Sciences (S.T., K.R., A.-K.P., K.H., J.L., R.P., M.L.), Hospital for Children and Adolescents, Institute of Clinical Medicine (E.K.), and Department of General Practice and Primary Health Care (J.G.E.), University of Helsinki, Helsinki; Department of Chronic Disease Prevention (E.K., H.A., J.G.E.), National Institute for Health and Welfare, Helsinki; Centre for Military Medicine (M.H.), Finnish Defence Forces, Lahti; National Supervisory Authority for Welfare and Health (M.H.), Helsinki; National Defence College (J.T.L.), Finnish Defence Forces, Helsinki, Finland; Medical Research Council Epidemiology Resource Centre (C.O., D.J.P.B.) and Developmental Origins of Health and Disease Centre (D.J.P.B.), University of Southampton, Southampton, UK; Helsinki University Central Hospital (J.G.E.), Unit of General Practice, Helsinki; Folkhälsan Research Centre (J.G.E.), Helsinki; and Vasa Central Hospital (J.G.E.), Vasa, Finland.
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Eero Kajantie
From the Institute of Behavioral Sciences (S.T., K.R., A.-K.P., K.H., J.L., R.P., M.L.), Hospital for Children and Adolescents, Institute of Clinical Medicine (E.K.), and Department of General Practice and Primary Health Care (J.G.E.), University of Helsinki, Helsinki; Department of Chronic Disease Prevention (E.K., H.A., J.G.E.), National Institute for Health and Welfare, Helsinki; Centre for Military Medicine (M.H.), Finnish Defence Forces, Lahti; National Supervisory Authority for Welfare and Health (M.H.), Helsinki; National Defence College (J.T.L.), Finnish Defence Forces, Helsinki, Finland; Medical Research Council Epidemiology Resource Centre (C.O., D.J.P.B.) and Developmental Origins of Health and Disease Centre (D.J.P.B.), University of Southampton, Southampton, UK; Helsinki University Central Hospital (J.G.E.), Unit of General Practice, Helsinki; Folkhälsan Research Centre (J.G.E.), Helsinki; and Vasa Central Hospital (J.G.E.), Vasa, Finland.
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Markus Henriksson
From the Institute of Behavioral Sciences (S.T., K.R., A.-K.P., K.H., J.L., R.P., M.L.), Hospital for Children and Adolescents, Institute of Clinical Medicine (E.K.), and Department of General Practice and Primary Health Care (J.G.E.), University of Helsinki, Helsinki; Department of Chronic Disease Prevention (E.K., H.A., J.G.E.), National Institute for Health and Welfare, Helsinki; Centre for Military Medicine (M.H.), Finnish Defence Forces, Lahti; National Supervisory Authority for Welfare and Health (M.H.), Helsinki; National Defence College (J.T.L.), Finnish Defence Forces, Helsinki, Finland; Medical Research Council Epidemiology Resource Centre (C.O., D.J.P.B.) and Developmental Origins of Health and Disease Centre (D.J.P.B.), University of Southampton, Southampton, UK; Helsinki University Central Hospital (J.G.E.), Unit of General Practice, Helsinki; Folkhälsan Research Centre (J.G.E.), Helsinki; and Vasa Central Hospital (J.G.E.), Vasa, Finland.
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Jukka T. Leskinen
From the Institute of Behavioral Sciences (S.T., K.R., A.-K.P., K.H., J.L., R.P., M.L.), Hospital for Children and Adolescents, Institute of Clinical Medicine (E.K.), and Department of General Practice and Primary Health Care (J.G.E.), University of Helsinki, Helsinki; Department of Chronic Disease Prevention (E.K., H.A., J.G.E.), National Institute for Health and Welfare, Helsinki; Centre for Military Medicine (M.H.), Finnish Defence Forces, Lahti; National Supervisory Authority for Welfare and Health (M.H.), Helsinki; National Defence College (J.T.L.), Finnish Defence Forces, Helsinki, Finland; Medical Research Council Epidemiology Resource Centre (C.O., D.J.P.B.) and Developmental Origins of Health and Disease Centre (D.J.P.B.), University of Southampton, Southampton, UK; Helsinki University Central Hospital (J.G.E.), Unit of General Practice, Helsinki; Folkhälsan Research Centre (J.G.E.), Helsinki; and Vasa Central Hospital (J.G.E.), Vasa, Finland.
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Anu-Katriina Pesonen
From the Institute of Behavioral Sciences (S.T., K.R., A.-K.P., K.H., J.L., R.P., M.L.), Hospital for Children and Adolescents, Institute of Clinical Medicine (E.K.), and Department of General Practice and Primary Health Care (J.G.E.), University of Helsinki, Helsinki; Department of Chronic Disease Prevention (E.K., H.A., J.G.E.), National Institute for Health and Welfare, Helsinki; Centre for Military Medicine (M.H.), Finnish Defence Forces, Lahti; National Supervisory Authority for Welfare and Health (M.H.), Helsinki; National Defence College (J.T.L.), Finnish Defence Forces, Helsinki, Finland; Medical Research Council Epidemiology Resource Centre (C.O., D.J.P.B.) and Developmental Origins of Health and Disease Centre (D.J.P.B.), University of Southampton, Southampton, UK; Helsinki University Central Hospital (J.G.E.), Unit of General Practice, Helsinki; Folkhälsan Research Centre (J.G.E.), Helsinki; and Vasa Central Hospital (J.G.E.), Vasa, Finland.
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Kati Heinonen
From the Institute of Behavioral Sciences (S.T., K.R., A.-K.P., K.H., J.L., R.P., M.L.), Hospital for Children and Adolescents, Institute of Clinical Medicine (E.K.), and Department of General Practice and Primary Health Care (J.G.E.), University of Helsinki, Helsinki; Department of Chronic Disease Prevention (E.K., H.A., J.G.E.), National Institute for Health and Welfare, Helsinki; Centre for Military Medicine (M.H.), Finnish Defence Forces, Lahti; National Supervisory Authority for Welfare and Health (M.H.), Helsinki; National Defence College (J.T.L.), Finnish Defence Forces, Helsinki, Finland; Medical Research Council Epidemiology Resource Centre (C.O., D.J.P.B.) and Developmental Origins of Health and Disease Centre (D.J.P.B.), University of Southampton, Southampton, UK; Helsinki University Central Hospital (J.G.E.), Unit of General Practice, Helsinki; Folkhälsan Research Centre (J.G.E.), Helsinki; and Vasa Central Hospital (J.G.E.), Vasa, Finland.
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Jari Lahti
From the Institute of Behavioral Sciences (S.T., K.R., A.-K.P., K.H., J.L., R.P., M.L.), Hospital for Children and Adolescents, Institute of Clinical Medicine (E.K.), and Department of General Practice and Primary Health Care (J.G.E.), University of Helsinki, Helsinki; Department of Chronic Disease Prevention (E.K., H.A., J.G.E.), National Institute for Health and Welfare, Helsinki; Centre for Military Medicine (M.H.), Finnish Defence Forces, Lahti; National Supervisory Authority for Welfare and Health (M.H.), Helsinki; National Defence College (J.T.L.), Finnish Defence Forces, Helsinki, Finland; Medical Research Council Epidemiology Resource Centre (C.O., D.J.P.B.) and Developmental Origins of Health and Disease Centre (D.J.P.B.), University of Southampton, Southampton, UK; Helsinki University Central Hospital (J.G.E.), Unit of General Practice, Helsinki; Folkhälsan Research Centre (J.G.E.), Helsinki; and Vasa Central Hospital (J.G.E.), Vasa, Finland.
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Riikka Pyhälä
From the Institute of Behavioral Sciences (S.T., K.R., A.-K.P., K.H., J.L., R.P., M.L.), Hospital for Children and Adolescents, Institute of Clinical Medicine (E.K.), and Department of General Practice and Primary Health Care (J.G.E.), University of Helsinki, Helsinki; Department of Chronic Disease Prevention (E.K., H.A., J.G.E.), National Institute for Health and Welfare, Helsinki; Centre for Military Medicine (M.H.), Finnish Defence Forces, Lahti; National Supervisory Authority for Welfare and Health (M.H.), Helsinki; National Defence College (J.T.L.), Finnish Defence Forces, Helsinki, Finland; Medical Research Council Epidemiology Resource Centre (C.O., D.J.P.B.) and Developmental Origins of Health and Disease Centre (D.J.P.B.), University of Southampton, Southampton, UK; Helsinki University Central Hospital (J.G.E.), Unit of General Practice, Helsinki; Folkhälsan Research Centre (J.G.E.), Helsinki; and Vasa Central Hospital (J.G.E.), Vasa, Finland.
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Hanna Alastalo
From the Institute of Behavioral Sciences (S.T., K.R., A.-K.P., K.H., J.L., R.P., M.L.), Hospital for Children and Adolescents, Institute of Clinical Medicine (E.K.), and Department of General Practice and Primary Health Care (J.G.E.), University of Helsinki, Helsinki; Department of Chronic Disease Prevention (E.K., H.A., J.G.E.), National Institute for Health and Welfare, Helsinki; Centre for Military Medicine (M.H.), Finnish Defence Forces, Lahti; National Supervisory Authority for Welfare and Health (M.H.), Helsinki; National Defence College (J.T.L.), Finnish Defence Forces, Helsinki, Finland; Medical Research Council Epidemiology Resource Centre (C.O., D.J.P.B.) and Developmental Origins of Health and Disease Centre (D.J.P.B.), University of Southampton, Southampton, UK; Helsinki University Central Hospital (J.G.E.), Unit of General Practice, Helsinki; Folkhälsan Research Centre (J.G.E.), Helsinki; and Vasa Central Hospital (J.G.E.), Vasa, Finland.
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Marius Lahti
From the Institute of Behavioral Sciences (S.T., K.R., A.-K.P., K.H., J.L., R.P., M.L.), Hospital for Children and Adolescents, Institute of Clinical Medicine (E.K.), and Department of General Practice and Primary Health Care (J.G.E.), University of Helsinki, Helsinki; Department of Chronic Disease Prevention (E.K., H.A., J.G.E.), National Institute for Health and Welfare, Helsinki; Centre for Military Medicine (M.H.), Finnish Defence Forces, Lahti; National Supervisory Authority for Welfare and Health (M.H.), Helsinki; National Defence College (J.T.L.), Finnish Defence Forces, Helsinki, Finland; Medical Research Council Epidemiology Resource Centre (C.O., D.J.P.B.) and Developmental Origins of Health and Disease Centre (D.J.P.B.), University of Southampton, Southampton, UK; Helsinki University Central Hospital (J.G.E.), Unit of General Practice, Helsinki; Folkhälsan Research Centre (J.G.E.), Helsinki; and Vasa Central Hospital (J.G.E.), Vasa, Finland.
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Clive Osmond
From the Institute of Behavioral Sciences (S.T., K.R., A.-K.P., K.H., J.L., R.P., M.L.), Hospital for Children and Adolescents, Institute of Clinical Medicine (E.K.), and Department of General Practice and Primary Health Care (J.G.E.), University of Helsinki, Helsinki; Department of Chronic Disease Prevention (E.K., H.A., J.G.E.), National Institute for Health and Welfare, Helsinki; Centre for Military Medicine (M.H.), Finnish Defence Forces, Lahti; National Supervisory Authority for Welfare and Health (M.H.), Helsinki; National Defence College (J.T.L.), Finnish Defence Forces, Helsinki, Finland; Medical Research Council Epidemiology Resource Centre (C.O., D.J.P.B.) and Developmental Origins of Health and Disease Centre (D.J.P.B.), University of Southampton, Southampton, UK; Helsinki University Central Hospital (J.G.E.), Unit of General Practice, Helsinki; Folkhälsan Research Centre (J.G.E.), Helsinki; and Vasa Central Hospital (J.G.E.), Vasa, Finland.
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David J.P. Barker
From the Institute of Behavioral Sciences (S.T., K.R., A.-K.P., K.H., J.L., R.P., M.L.), Hospital for Children and Adolescents, Institute of Clinical Medicine (E.K.), and Department of General Practice and Primary Health Care (J.G.E.), University of Helsinki, Helsinki; Department of Chronic Disease Prevention (E.K., H.A., J.G.E.), National Institute for Health and Welfare, Helsinki; Centre for Military Medicine (M.H.), Finnish Defence Forces, Lahti; National Supervisory Authority for Welfare and Health (M.H.), Helsinki; National Defence College (J.T.L.), Finnish Defence Forces, Helsinki, Finland; Medical Research Council Epidemiology Resource Centre (C.O., D.J.P.B.) and Developmental Origins of Health and Disease Centre (D.J.P.B.), University of Southampton, Southampton, UK; Helsinki University Central Hospital (J.G.E.), Unit of General Practice, Helsinki; Folkhälsan Research Centre (J.G.E.), Helsinki; and Vasa Central Hospital (J.G.E.), Vasa, Finland.
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Johan G. Eriksson
From the Institute of Behavioral Sciences (S.T., K.R., A.-K.P., K.H., J.L., R.P., M.L.), Hospital for Children and Adolescents, Institute of Clinical Medicine (E.K.), and Department of General Practice and Primary Health Care (J.G.E.), University of Helsinki, Helsinki; Department of Chronic Disease Prevention (E.K., H.A., J.G.E.), National Institute for Health and Welfare, Helsinki; Centre for Military Medicine (M.H.), Finnish Defence Forces, Lahti; National Supervisory Authority for Welfare and Health (M.H.), Helsinki; National Defence College (J.T.L.), Finnish Defence Forces, Helsinki, Finland; Medical Research Council Epidemiology Resource Centre (C.O., D.J.P.B.) and Developmental Origins of Health and Disease Centre (D.J.P.B.), University of Southampton, Southampton, UK; Helsinki University Central Hospital (J.G.E.), Unit of General Practice, Helsinki; Folkhälsan Research Centre (J.G.E.), Helsinki; and Vasa Central Hospital (J.G.E.), Vasa, Finland.
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Citation
Hypertensive disorders in pregnancy and cognitive decline in the offspring up to old age
Soile Tuovinen, Katri Räikkönen, Eero Kajantie, Markus Henriksson, Jukka T. Leskinen, Anu-Katriina Pesonen, Kati Heinonen, Jari Lahti, Riikka Pyhälä, Hanna Alastalo, Marius Lahti, Clive Osmond, David J.P. Barker, Johan G. Eriksson
Neurology Oct 2012, 79 (15) 1578-1582; DOI: 10.1212/WNL.0b013e31826e2606

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Abstract

Objective: We tested whether maternal hypertensive disorders in pregnancy predict age-related change in cognitive ability in the offspring up to old age.

Methods: Using mothers' blood pressure and urinary protein measurements from the maternity clinics and birth hospitals, we defined normotensive or hypertensive pregnancies in mothers of 398 men, who participated in the Helsinki Birth Cohort 1934–1944 Study. The men underwent the Finnish Defence Forces basic ability test twice: first during compulsory military service at age 20.1 (SD = 1.4) years and then in a retest at age 68.5 (SD = 2.9) years. The test yields a total score and subscores for tests measuring verbal, arithmetic, and visuospatial reasoning.

Results: Men born after pregnancies complicated by a hypertensive disorder, compared with men born after normotensive pregnancies, scored 4.36 (95% confidence interval, 1.17–7.55) points lower on total cognitive ability at 68.5 years and displayed a greater decline in total cognitive ability (2.88; 95% confidence interval, 0.07–5.06) after 20.1 years. Of the subscores, associations were strongest for arithmetic reasoning.

Conclusion: Maternal hypertensive disorders in pregnancy predict lower cognitive ability and greater cognitive decline up to old age. A propensity to lower cognitive ability and decline up to old age may have prenatal origins.

GLOSSARY

CHD=
coronary heart disease;
HBCS=
Helsinki Birth Cohort Study

Footnotes

  • Study funding: Supported by grants from the Academy of Finland, European Science Foundation (EuroSTRESS), University of Helsinki, the British Heart Foundation, the Finnish Foundation of Cardiovascular Research, the Finnish Diabetes Research Foundation, the Finnish Medical Society (Duodecim), Finska Läkaresällskapet, the National Doctoral Programme of Psychology, the Päivikki and Sakari Sohlberg Foundation, the Juho Vainio Foundation, the Yrjö Jahnsson Foundation, the Signe and Ane Gyllenberg Foundation, the Jalmari and Rauha Ahokas Foundation, the Emil Aaltonen Foundation, the Finnish Ministry of Education, and the Finnish Foundation for Paediatric Research.

  • Supplemental data at www.neurology.org

  • Received January 30, 2012.
  • Accepted May 24, 2012.
  • Copyright © 2012 by AAN Enterprises, Inc.
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