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CHIPS-Child: Testing the developmental programming hypothesis in the offspring of the CHIPS trial
Laura A Magee1, Anne R Synnes2, Peter von Dadelszen1
1Department of Women and Children's Health, King's College London, UK; School of Life Course Sciences, King's College London, UK.
Pregnancy Hypertension
|December 12, 2018
Summary
This study found no evidence that controlling maternal blood pressure in pregnancy affects children's growth or stress response. Further research is needed on neurodevelopment and blood pressure in children.
Area of Science:
- Obstetrics and Gynecology
- Pediatrics
- Endocrinology
Background:
- The CHIPS trial (Control of Hypertension In Pregnancy Study) previously examined 'less tight' versus 'tight' maternal blood pressure control during pregnancy.
- Investigating potential long-term effects on child development is crucial for understanding the impact of prenatal care strategies.
Purpose of the Study:
- To assess the impact of different maternal blood pressure control strategies during pregnancy on postnatal growth and hypothalamic-pituitary adrenal (HPA) axis activation in children.
- To investigate potential developmental programming related to maternal hypertension management.
Main Methods:
- Follow-up of children from the CHIPS trial up to 12 months corrected post-gestational age for anthropometric measurements.
- Collection of biological samples (hair and buccal swabs) to analyze hair cortisol levels and DNA methylation.
- Primary outcome: change in weight z-score from birth to 12 months; secondary outcomes: hair cortisol and DNA methylation patterns.
Main Results:
- No significant differences in growth rate (weight z-score change) were observed between the 'less tight' and 'tight' blood pressure control groups.
- Median hair cortisol levels were lower in the 'less tight' control group (p=0.02), suggesting a potential difference in HPA axis activation.
- Buccal swab DNA methylation patterns were similar between groups, and no growth differences were found up to 5 years.
Conclusions:
- The study found no compelling evidence for developmental programming of growth or the HPA axis based on maternal blood pressure control strategies.
- Clinical practice should continue to be guided by the primary findings of the CHIPS trial.
- Further research is recommended to replicate these findings and explore impacts on pediatric blood pressure and neurodevelopment.
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