Placental pathology and childhood cognitive and motor development

In order to examine the effects of placental pathology on developmental outcome, 39 children between the ages of 3 and 9 were tested on measures of cognitive and motor development. All participants were born to women diagnosed with hypertension during pregnancy and, therefore, were at increased risk for placental pathology. To test the hypothesis that degree of placental pathology is inversely linked with cognitive and motor outcome, children were compared on the basis of chronicity of placental pathology, severity of placental pathology, presence or absence of specific placental lesions, and fetal/placental weight ratio. It was hypothesized that since placental pathology is associated with damage to areas of the brain associated with motor function, motor skills, as compared to cognitive skills, are more likely to be compromised following placental damage. To test the hypotheses, the VIQ and PIQ from the WPPSI-R (Wechsler, 1989) or WISC-III (Wechsler, 1991) and the z scores for fine and gross motor outcome {lcub}based on PDMSAC (Folio & Fewell, 1983), MSCA (McCarthy, 1972), and BOTMP (Bruininks, 1978) performance{rcub} were used as dependent measures in separate mixed linear model multivariate analyses. Covariates included gestational age, sex, presence of suboptimal intrauterine growth, SES, highest maternal blood pressure, and type of motor test administered. Results indicated that no predictor of placental pathology was significantly associated with cognitive or motor performance. However, suboptimal intrauterine growth, a correlate of severe placental pathology, was significantly associated with motor outcome (Wilks' Λ = .74, F [2,26] = 4.50, p = .02), and gestational age (Wilks' Λ = .81, F [2,32] = 3.70, p = .04) was significantly associated with IQ score. The current study indicates that infant traits, such as intrauterine growth and gestational age, rather than maternal or placental characteristics, are the most accurate indicators of in utero environment and subsequent cognitive and motor development.