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, 1.88; 95% CI, 1.20-2.93). 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.