(HealthDay)—Exposure to hypertensive disorders of pregnancy (HDP) may be associated with an increase in the risk of autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD) in offspring, according to a review published online June 6 in JAMA Psychiatry

Gillian M. Maher, M.P.H., from University College Cork in Ireland, and colleagues conducted a systematic literature review to assess the association between HDP and neurodevelopmental outcome in offspring. The authors included 61 cohort and case-control studies in their analysis.

The researchers found that 11 of 20 studies that reported estimates for ASD (777,518 participants) found higher odds with HDP (adjusted odds ratio [aOR], 1.35) in a pooled analysis.

For the six studies reporting adjusted estimates of ADHD (1,395,605 participants), the pooled adjusted OR was 1.29. There were no statistically significant differences for ASD or ADHD in subgroup analyses according to the type of exposure (i.e., preeclampsia or other HDP).

Main Outcome

Of 1166 studies identified, 61 unique articles met inclusion criteria. Twenty studies reported estimates for ASD. Eleven of these (including 777?518 participants) reported adjusted estimates, with a pooled adjusted OR of 1.35 (95% CI, 1.11-1.64).

Ten studies reported estimates for ADHD. Six of these (including 1?395?605 participants) reported adjusted estimates, with a pooled adjusted OR of 1.29 (95% CI, 1.22-1.36). Subgroup analyses according to the type of exposure (ie, preeclampsia or other HDP) showed no statistically significant differences for ASD or ADHD.

Thirty-one studies met inclusion criteria for all other neurodevelopmental disorders. Individual estimates reported for these were largely inconsistent, with few patterns of association observed.

Random-effects meta-analyses of estimated pooled odds ratios (ORs) for HDP and ASD and for HDP and ADHD. Stand-alone estimates were reported for all other neurodevelopmental disorders.

"These findings highlight the need for greater pediatric surveillance of infants exposed to HDP to allow early intervention that may improve neurodevelopmental outcome," the authors write.

Exposure to HDP may be associated with an increase in the risk of ASD and ADHD. These findings highlight the need for greater pediatric surveillance of infants exposed to HDP to allow early intervention that may improve neurodevelopmental outcome.