Pregnancy trauma and risks of hypoxia, convulsions, cerebral palsy and respiratory complications in offspring.

OBJECTIVES

Pregnancy trauma affects 5% to 8% of pregnancies, yet evidence regarding neurological and respiratory consequences for offspring remains limited. The authors investigated the association between pregnancy trauma and adverse neurological and respiratory outcomes in children.

METHOD: This population-based cohort study used linked data from the Taiwan National Health Insurance Research Database and Maternal and Child Health Database. The study included 2,018,401 mother-infant pairs between 2004 and 2020. Mothers with pregnancy trauma (n = 55,500) were matched 1:4 with mothers without pregnancy trauma (n = 222,000) based on maternal age, neonatal sex, and birth month. Participants were followed up through December 31, 2023. Adjusted hazard ratios (aHRs) were estimated using multivariable Cox proportional hazards regression.

RESULTS

Compared with controls, children of exposed pregnancy trauma had significantly increased risks of intrauterine hypoxia and birth asphyxia (aHR, 1.57; 95% CI, 1.13-2.18), composite neonatal respiratory morbidity (aHR, 1.12; 95% CI, 1.03-1.22), convulsions in newborn (aHR, 1.45; 95% CI, 1.04-2.03) and cerebral palsy, unspecified (aHR, 1.26; 95% CI, 1.06-1.51). Risks were markedly higher when pregnancy trauma required hospitalization (aHR for intrauterine hypoxia and birth asphyxia, 3.29; 95% CI, 1.67-6.50; composite neonatal respiratory morbidity, 1.43; 95% CI, 1.14-1.79) or occurred during the second trimester (hypoxia and asphyxia, 1.91; 95% CI, 1.22-2.98).

CONCLUSION

Pregnancy trauma is associated with increased risks of adverse neurological and respiratory outcomes in offspring, particularly following severe or second-trimester trauma. These findings highlight the need for pregnancy trauma prevention and underscore the importance of appropriate postnatal care and neurological surveillance for offspring exposed to pregnancy trauma.