Maternal Early‐Pregnancy Cardiovascular Health and Offspring Emotional, Behavioral, and Cognitive Outcomes in Adolescence

Background: Maternal cardiovascular health in early pregnancy is critical for fetal brain development and may affect long‐term outcomes in the offspring. We assessed the associations of maternal early‐pregnancy cardiovascular health with childhood emotional, behavioral, and cognitive outcomes at 13 years. Methods: This study was embedded in a population‐based prospective cohort study from fetal life onwards among 3680 mother–child dyads. Maternal early‐pregnancy cardiovascular health was defined according to an adapted Life's Simple 7 score based on body mass index, blood pressure, blood glucose, lipid concentrations, and smoking. Childhood outcomes included total, internalizing, and externalizing problems and attention‐deficit hyperactive disorder symptoms assessed by the parent‐reported Child Behavior Checklist, autistic symptoms by the Social Responsiveness Scale, and estimated full‐scale intelligence quotient by a subset of the Wechsler Intelligence Scale for Children‐Fifth Edition. Results: As compared with children from mothers with ideal early‐pregnancy cardiovascular health, those from mothers with suboptimal cardiovascular health had increased odds of high scores for total problems (odds ratio OR, 1.29 95% CI, 1.08–1.54), externalizing problems (OR, 1.25 95% CI, 1.06–1.48), attention‐deficit hyperactive disorder symptoms (OR, 1.34 95% CI, 1.14–1.58), and borderline low intelligent quotient (IQ) (OR, 1.55 95% CI, 1.11–2.15). Conclusion: Suboptimal early‐pregnancy cardiovascular health is associated with increased odds of emotional, behavioral, and cognitive outcomes in the offspring. Optimizing cardiovascular health in early pregnancy might contribute to better development and later life neurodevelopmental outcomes in the offspring.