It is unclear whether the microalbuminuria associated with previous preeclampsia represents underlying renal disease or is an independent cardiovascular risk
marker [504]. That early testing (and intervention) for cardiovascular and renal risk factors will improve cardiovascular outcomes is unproven. Birinapant mw Barriers to compliance with a healthy diet and lifestyle include poor postpartum physical and psychological recovery, and lack of postpartum medical and psychological support from healthcare providers [505]. Be aware of a growing literature describing adverse effects of preeclampsia on offspring cardiovascular [506] and reproductive health [507]. 1. Clinicians should be aware that gestational hypertension and preeclampsia may each be associated with an increase in adverse paediatric neurodevelopmental effects, such as inattention and externalizing behaviours (e.g., aggressiveness) (II2-B; Very low/Weak). Superimposed preeclampsia (vs. pre-existing hypertension alone) has no adverse effect on (or slightly better) intellectual development (no information given on antihypertensives) [508]. Gestational hypertension and preeclampsia may predict
Selleck ABT-263 generally modest long term effects on child development. Children of women with preeclampsia had reduced internalizing morbidity (e.g., anxiety) at ages 5 and 8 years, but children of women with gestational hypertension were more likely to have poorer behaviour from 8 years onwards, with the largest difference seen at 14 years (no information given on antihypertensives) [509]. Both types of HDP were associated with a small reduction in verbal ability of uncertain clinical significance
[510]. Little information was provided on antihypertensives which were considered as a covariate. Babies of antihypertensive (mainly methyldopa)-treated mothers (vs. normtensive controls) have excess delayed fine-motor function at 6 months Metalloexopeptidase of age, while those of placebo-treated hypertensive mothers more frequently had ‘questionable’ neurological assessment and delayed gross-motor function at 12 months [511]. However other small RCTs of methyldopa [512], atenolol [347], and nifedipine [513] did not observe negative impacts on child development. Methyldopa (but not labetalol) may be associated with lower IQ; the duration of treatment being an independent negative predictor of children’s Performance IQ [514]. 1. Health care providers should be alert to symptoms of post-traumatic stress following a HDP; and refer women for appropriate evaluation and treatment (II-2B; Low/Weak). We support incorporating the patient perspective into care. Engaged patient advocacy organizations are the Preeclampsia Foundation www.preeclampsia.