Do maternal and intrauterine factors influence blood pressure in childhood?

It has been proposed that maternal health and nutrition may be important in the development of adult cardiovascular risk, and that blood pressure may be an important intermediate step in this process. To examine the relevance of this hypothesis in contemporary British children, the relationships of several maternal factors to blood pressure were studied in 3360 children of European origin aged 5-7 years. Maternal age, height, and body mass index were all positively related to blood pressure in childhood but these relationships were abolished once the child's body build was taken into account. Maternal social class, educational attainment, and history of smoking in pregnancy showed no relationship with blood pressure in childhood. Parity showed an inverse association with blood pressure, but this appeared to be due to an association between total sibship size and blood pressure, suggesting a postnatal rather than a prenatal origin. Blood pressure was higher in children whose mothers had a history of high blood pressure but this association was no stronger than that for paternal history. Both birth weight and gestational age were inversely related to blood pressure at 5-7 years. The association between birth weight and blood pressure was attenuated by standardisation for gestational age, and the relationships between birth weight and blood pressure were similar in preterm and full term infants. No specific association between blood pressure and the maternal factors studied have been observed in this population. Hypotheses relating maternal factors to cardiovascular risk need to specify the timing and nature of their effects more precisely. Although the relationship between birth weight and blood pressure is not fully understood, it appears to reflect size at birth rather than fetal growth rate.