What question did this study set out to answer?

To explore how maternal cardiovascular health in early pregnancy relates to children's emotional, behavioral, and cognitive outcomes at 13 years.

April 10, 2026Open Access

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

Key Result

Suboptimal maternal cardiovascular health in early pregnancy is associated with increased odds of adverse emotional, behavioral, and cognitive outcomes in adolescent offspring.

Key Points

To explore how maternal cardiovascular health in early pregnancy relates to children's emotional, behavioral, and cognitive outcomes at 13 years.
Analyzed data from a cohort of 3680 mother-child pairs.
Evaluated maternal cardiovascular health using an adapted Life's Simple 7 score.
Assessed childhood outcomes using various behavioral and cognitive assessment scales.
Children of mothers with suboptimal cardiovascular health had higher odds of emotional and behavioral problems.
Those children also showed increased rates of attention-deficit hyperactive disorder symptoms.
Higher odds of borderline low intelligent quotient were observed among children from mothers with poorer cardiovascular health.

Structured PICO

Does suboptimal maternal early-pregnancy cardiovascular health increase the risk of adverse emotional, behavioral, and cognitive outcomes in offspring at 13 years?

Population

3680 mother-child dyads from a population-based prospective cohort study from fetal life onwards

Intervention

Suboptimal maternal early-pregnancy cardiovascular health (defined by an adapted Life's Simple 7 score based on body mass index, blood pressure, blood glucose, lipid concentrations, and smoking)

Comparator

Ideal maternal early-pregnancy cardiovascular health

Outcome

Childhood emotional, behavioral, and cognitive outcomes at 13 years (including total, internalizing, and externalizing problems, attention-deficit hyperactive disorder symptoms, autistic symptoms, and estimated full-scale intelligence quotient)patient reported

Suboptimal maternal cardiovascular health in early pregnancy is associated with increased odds of adverse emotional, behavioral, and cognitive outcomes in offspring at 13 years of age.

Main Result

Absolute Event Rate: 0% vs 0%

Abstract

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.