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Maternal Blood Pressure During Pregnancy and Early Childhood Blood Pressures in the Offspring: The GUSTO Birth Cohort
Wai-Yee Lim1, Yung-Seng Lee, Fabian Kok-Peng Yap
1From the Saw Swee Hock School of Public Health, National University of Singapore and National University Health System (WYL, SSM), KK Women's and Children's Hospital (WYL, FKPY, NL, KK), Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (ASTAR) (YSL, IMA, MM, PDG, YSC), Clinical Nutrition Research Centre, Singapore Institute for Clinical Sciences, ASTAR and National University Health System (YSL, PDG, YSC), Department of Paediatrics, Yong Loo Lin School of Medicine (YSL), Yong Loo Lin School of Medicine, National University of Singapore and National University Health System (YSL, FKPY, KK, YSC, SSM), Duke-NUS Graduate Medical School, National University of Singapore, Singapore (FKPY, NL, KK), Ludmer Centre for Neuroinformatics and Mental Health University Institute (MM), Sackler Program for Epigenetics and Psychobiology, McGill University, Canada (MM), Liggins Institute, University of Auckland, Auckland, New Zealand (PDG), Human Development and Health Academic Unit, Faculty of Medicine, University of Southampton (KMG), NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust (KMG), Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK (KMG), Department of Obstetrics and Gynecology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore (YSC), and School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China (AP).
Insights
Maternal central blood pressure during pregnancy is linked to higher blood pressure in offspring. This association is observable by age three, suggesting potential long-term cardiovascular implications for children born to mothers with elevated central blood pressure.
Area of Science:
- Cardiovascular Physiology
- Perinatal Medicine
- Pediatric Cardiology
Background:
- Epidemiological studies indicate offspring of preeclamptic mothers face increased risks of hypertension and cardiovascular disease.
- The specific relationship between maternal and offspring blood pressure components, particularly central versus peripheral measurements, remains underexplored.
- Understanding these intergenerational blood pressure dynamics is crucial for early cardiovascular risk assessment.
Purpose of the Study:
- To investigate the association between maternal peripheral and central blood pressure components during pregnancy and offspring blood pressure in early childhood.
- To differentiate the impact of pulsatile (systolic blood pressure [SBP] and pulse pressure [PP]) versus stable (diastolic blood pressure [DBP]) blood pressure components.
- To examine these associations across diverse ethnic groups within a prospective birth cohort.
Main Methods:
- A prospective cohort study of 567 mother-offspring pairs from Chinese, Malay, and Indian ethnic groups.
- Maternal brachial artery and estimated central blood pressure (SBP, DBP, PP) measured during mid-pregnancy (26-28 weeks gestation).
- Offspring peripheral blood pressure (SBP, DBP, PP) measured at 3 years of age, with statistical adjustments for relevant maternal and offspring characteristics.
Main Results:
- Maternal central systolic blood pressure (SBP) and central pulse pressure (PP) during pregnancy were significantly associated with higher offspring peripheral SBP and PP at age 3.
- Specifically, a 1-mmHg increase in maternal central SBP correlated with a 0.08 mmHg increase in offspring SBP (P=0.06).
- A 1-mmHg increase in maternal central PP correlated with a 0.10 mmHg increase in offspring PP (P=0.03), while maternal-offspring peripheral blood pressure relationships were not statistically significant.
Conclusions:
- Maternal central pulsatile blood pressure components (SBP and PP) during pregnancy are associated with elevated blood pressure in offspring by age three.
- These findings highlight an early-life link between maternal hemodynamic status and offspring cardiovascular parameters.
- Further research is warranted to explore the long-term cardiovascular health implications for offspring exposed to maternal central pulsatile hypertension during gestation.
Abstract:
Although epidemiological studies suggest that offspring of women with preeclampsia are at increased risk to higher blood pressures and cardiovascular disease, little is known about the nature of blood pressures between the mother and her offspring. As blood pressures comprise of both pulsatile (systolic blood pressure [SBP] and pulse pressure [PP]) and stable (diastolic blood pressure [DBP]) components, and they differ between central and peripheral sites, we sought to examine maternal peripheral and central blood pressure components in relation to offspring early childhood blood pressures. A prospective birth cohort of 567 Chinese, Malay, and Indian mother-offspring with complete blood pressure information were studied. Maternal brachial artery SBP, DBP, and PP were measured at 26 to 28 weeks gestation; and central SBP and PP were estimated from radial artery waveforms. Offspring brachial artery SBP, DBP, and PP were measured at 3 years of age. Associations between continuous variables of maternal blood pressures (peripheral SBP, DBP, PP, central SBP, and PP) and offspring blood pressures (peripheral SBP, DBP, and PP) were examined using multiple linear regression with adjustment for maternal characteristics (age, education level, parity, smoking status, alcohol consumption and physical activity during pregnancy, and pre-pregnancy BMI) and offspring characteristics (sex, ethnicity, BMI, and height at 3 years of age). In the multivariate models, offspring peripheral SBP increased by 0.08 (95% confidence interval 0.00-0.17, P = 0.06) mmHg with every 1-mmHg increase in maternal central SBP, and offspring peripheral PP increased by 0.10 (0.01-0.18, P = 0.03) mmHg for every 1-mmHg increase in maternal central PP. The relations of maternal-offspring peripheral blood pressures (SBP, DBP, and PP) were positive but not statistically significant, and the corresponding values were 0.05 (-0.03 to 0.13; P = 0.21), 0.03 (-0.04 to 0.10; P = 0.35), and 0.05 (-0.02 to 0.13; P = 0.14), respectively. Maternal central pulsatile blood pressure components (SBP and PP) during pregnancy are associated with higher blood pressures in the offspring. This positive correlation is already evident at 3-years old. Studies are needed to further evaluate the effects of maternal central pulsatile blood pressure components during pregnancy and long-term cardiovascular health in the offspring.
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