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Pregnancy-Associated Hypertension and Offspring Cardiometabolic Health
Madeline Murguia Rice1, Mark B Landon, Michael W Varner
1George Washington University Biostatistics Center, Washington, DC; and the Departments of Obstetrics and Gynecology, The Ohio State University, Columbus, Ohio, University of Utah Health Sciences Center, Salt Lake City, Utah, University of Texas Southwestern Medical Center, Dallas, Texas, Columbia University, New York, New York, Brown University, Providence, Rhode Island, University of Alabama at Birmingham, Birmingham, Alabama, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, MetroHealth Medical Center-Case Western Reserve University, Cleveland, Ohio, University of Texas Medical Branch, Galveston, Texas, Northwestern University, Chicago, Illinois, and University of Texas Health Science Center at Houston-Children's Memorial Hermann Hospital, Houston, Texas; and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland.
Insights
Pregnancy-associated hypertension in mothers was linked to higher systolic blood pressure in their children. This finding highlights potential long-term cardiometabolic risks for offspring.
Area of Science:
- Obstetrics and Gynecology
- Pediatrics
- Cardiology
Background:
- Pregnancy-associated hypertension, including gestational hypertension and preeclampsia, affects maternal and potentially fetal health.
- Understanding the long-term cardiometabolic health of offspring exposed to hypertensive pregnancies is crucial.
Purpose of the Study:
- To investigate the association between pregnancy-associated hypertension and cardiometabolic risk factors in young children.
Main Methods:
- A prospective observational follow-up study of 979 children aged 5-10 years.
- Assessed cardiometabolic risk factors including blood pressure, BMI, waist circumference, glucose, and lipids.
- Adjusted for confounding factors in the analysis.
Main Results:
- Children born at term to mothers with pregnancy-associated hypertension had significantly higher adjusted systolic blood pressure (104 mm Hg vs 99 mm Hg).
- No significant differences were observed in diastolic blood pressure, BMI, waist circumference, glucose, or lipid levels.
- Preterm birth from hypertensive pregnancies was also analyzed but did not show significant differences in the primary outcomes.
Conclusions:
- Pregnancy-associated hypertension in term deliveries is associated with elevated systolic blood pressure in offspring.
- This association did not extend to other cardiometabolic risk factors in this cohort.
- Further research may explore the mechanisms linking maternal hypertension to offspring cardiovascular health.
Objective:
To evaluate whether pregnancy-associated hypertension (gestational hypertension and preeclampsia) was associated with the cardiometabolic health of young offspring.
Methods:
This was a prospective observational follow-up study from 2012 to 2013 of children born to women previously enrolled in a mild gestational diabetes mellitus treatment trial or nongestational diabetes mellitus observational study. At 5-10 years after birth, children were examined and fasting blood samples obtained to determine the following cardiometabolic risk factors: blood pressure (BP), high-density lipoprotein cholesterol, triglycerides, glucose, homeostatic model assessment of insulin resistance, waist circumference, and body mass index (BMI).
Results:
This analysis included 979 children evaluated at a median 7 years of age. Twenty-three (2%) were born preterm from a hypertensive pregnancy, 73 (7%) were born at term from a hypertensive pregnancy, 58 (6%) were born preterm from a normotensive pregnancy, and 825 (84%) were born at term from a normotensive pregnancy (reference group). After adjusting for confounding factors, mean adjusted systolic BP was significantly higher in the children who were born at term to mothers who experienced pregnancy-associated hypertension compared with those born at term to normotensive mothers (systolic BP of 104 mm Hg, 95% CI 101-106 vs systolic BP of 99 mm Hg, 95% CI 99-100, P=.001). No other significant differences were observed.
Conclusion:
Pregnancy-associated hypertension in women who deliver at term was associated with higher systolic BP in the offspring, but not with their measures of diastolic BP, BMI, waist circumference, homeostatic model assessment of insulin resistance, glucose, or lipids.
Clinical Trial Registration:
ClinicalTrials.gov, NCT00069576.
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