Abstract / Summary
Abstract Background Maternal hypertensive disorders of pregnancy, including pregnancy-induced hypertension (PIH) and preeclampsia, may influence fetal brain development through placental dysfunction, inflammation, oxidative stress, and prematurity-related pathways. Evidence from non-Western birth cohorts remains limited, particularly for domain-specific neurodevelopment during infancy. Methods We analyzed 3,108 mother-child pairs from the PERSIAN Birth Cohort with available maternal hypertensive-disorder data and 12-month neurodevelopmental assessment. Infant neurodevelopment was evaluated using the Ages and Stages Questionnaire (ASQ) across five domains: communication, gross motor, fine motor, problem solving, and personal-social development. Mean ASQ scores were compared by PIH and preeclampsia exposure status. Linear regression models were fitted for each ASQ domain and adjusted for maternal age, maternal body mass index, socioeconomic status (SES), and gestational age at delivery. Results are presented as beta coefficients (β), standard errors (SE), and two-sided p values. Results Infants exposed to PIH had lower adjusted gross motor (β = -2.44, SE = 1.17, p = 0.037), fine motor (β = -1.89, SE = 0.77, p = 0.013), and problem-solving scores (β = -1.72, SE = 0.84, p = 0.039) than unexposed infants. Similar patterns were observed for preeclampsia, with lower adjusted gross motor (β = -3.07, SE = 1.31, p = 0.019), fine motor (β = -2.36, SE = 0.85, p = 0.006), and problem-solving scores (β = -2.20, SE = 0.93, p = 0.018). Communication and personal-social scores were not significantly associated with either exposure. Conclusion In this PERSIAN Birth Cohort sub-study, PIH and preeclampsia were associated with modest but consistent reductions in motor and problem-solving ASQ scores at 12 months. These findings support targeted developmental surveillance for infants exposed to hypertensive disorders in utero, while emphasizing the need for longer follow-up in future studies.