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American Journal of Epidemiology Advance Access originally published online on September 2, 2009
American Journal of Epidemiology 2009 170(8):1025-1031; doi:10.1093/aje/kwp223
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American Journal of Epidemiology © The Author 2009. Published by the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org.

ORIGINAL CONTRIBUTIONS

Pregnancy-associated Hypertensive Disorders and Adult Cognitive Function Among Danish Conscripts

Vera Ehrenstein, Kenneth J. Rothman, Lars Pedersen, Elizabeth E. Hatch and Henrik Toft Sørensen

Correspondence to Dr. Vera Ehrenstein, Department of Clinical Epidemiology, Aarhus University Hospital, Olof Palmes Allé 43-45, 8200 Aarhus N, Denmark (e-mail: ve{at}dce.au.dk).

Received for publication March 9, 2009. Accepted for publication June 30, 2009.

The authors examined the association of gestational hypertensive disorders (hypertension, preeclampsia, eclampsia) with adult cognitive function among men born in 1978–1983 in a well-defined geographic area of northern Denmark. Data from the Danish Medical Birth Registry, the Danish National Registry of Patients, and draft board records were linked. Cognitive function was measured at conscription by using the Boerge Prien group intelligence test. Test scores were converted to the conventional IQ scale (mean = 100 (standard deviation, 15)). Low cognitive function was defined as IQ <85. Of the 17,457 men who underwent intelligence testing, 891 (5.1%) were born after a pregnancy involving hospitalization for a gestational hypertensive disorder. Compared with conscripts born after normotensive pregnancy, conscripts exposed to maternal gestational hypertension had an adjusted prevalence ratio for low cognitive function of 1.34 (95% confidence interval (CI): 1.01, 1.77). For those exposed to mild preeclampsia and severe preeclampsia/eclampsia, adjusted prevalence ratios were 1.34 (95% CI: 1.09, 1.65) and 1.10 (95% CI: 0.48, 2.51), respectively. The corresponding adjusted mean differences in IQ scores were –2.0 (95% CI: –4.0, 0.0), –3.2 (95% CI: –4.7, –1.8), and –2.0 (95% CI: –7.2, 3.2). In this study, prenatal exposure to gestational hypertensive disorders was associated with slightly reduced adult cognitive performance among male conscripts.

hypertension; intelligence; pre-eclampsia; pregnancy

Abbreviations: BPP, Børge Prien Prøve; CI, confidence interval; ICD-8, International Classification of Diseases, Eighth Revision; ICD-10, International Statistical Classification of Diseases and Related Health Problems, Tenth Revision; PR, prevalence ratio; sFlt-1, soluble fms-like tyrosine kinase-1


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