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Diurnal Urinary Aldosterone Excretion and Potassium Intake During Pregnancy Are Associated With High Normal Blood
Hajir Al-Jorani1,2, Richard Christian Jensen1,3, Tina K Jensen3,4
1Department of Endocrinology Odense University Hospital Odense Denmark.
Insights
Maternal aldosterone and higher potassium intake are linked to increased offspring blood pressure (OBP) in early childhood. Girls showed greater susceptibility to maternal potassium intake effects on OBP.
Area of Science:
- Reproductive Medicine
- Pediatric Endocrinology
- Maternal-Fetal Medicine
Background:
- Offspring blood pressure (OBP) may be influenced by prenatal programming.
- Maternal third-trimester aldosterone levels correlate with fetoplacental development.
- Dietary recommendations for adults include high potassium and low sodium for normal renal function.
Purpose of the Study:
- To investigate the association between maternal third-trimester 24-hour urine aldosterone levels and offspring blood pressure (OBP).
- To examine the influence of maternal potassium and sodium intake on the relationship between maternal aldosterone and OBP.
Main Methods:
- Prospective study of 475 mother-child dyads in the Odense Child Cohort (OCC).
- Collected maternal 24-hour urine aldosterone from gestational week 29.
- Measured offspring blood pressure (BP) at multiple time points (3, 18 months, 3, 5 years); maternal potassium and sodium intake estimated from 24-hour urine excretion.
Main Results:
- Elevated maternal aldosterone correlated with higher offspring systolic BP at 3 and 18 months.
- Increased maternal potassium intake (1000 mg/d) was associated with higher offspring systolic BP up to age 5, particularly in girls.
- No significant association was observed between maternal sodium intake and offspring BP.
Conclusions:
- Elevated maternal aldosterone and higher dietary potassium intake are associated with increased offspring blood pressure in early childhood, though within normal ranges.
- Girls appear more susceptible to the effects of maternal potassium intake on offspring blood pressure.
- Findings suggest a potential role for maternal diet and hormonal factors in programming offspring cardiovascular health.
Background:
Offspring blood pressure (OBP) may be programmed during pregnancy. Accordingly, maternal third-trimester 24-hour urine aldosterone levels are associated with fetoplacental trophic effects. Furthermore, high potassium and low sodium intakes are generally recommended in adults with normal renal function. We hypothesized that maternal 24-hour urine aldosterone levels were positively associated with OBP, and maternal intake of potassium and sodium may influence the association. The study aimed to investigate associations between maternal third-trimester 24-hour urine aldosterone, potassium and sodium intake, and OBP.
Methods:
In the prospective OCC (Odense Child Cohort), 475 mother-child dyads had 24-hour urine aldosterone from gestational week 29 and OBP (systolic and diastolic), at ages 3 and 18 months and 3 and 5 years. Maternal potassium and sodium intakes were calculated from 24-hour urine potassium and urine sodium excretions.
Results:
Increased maternal 24-hour urine aldosterone associated with higher systolic blood pressure in offspring at ages 3 months (β=0.54 mm Hg [95% CI, 0.29; 0.79]) and 18 months (β=0.24 mm Hg [95% CI, 0.03; 0.44]). One thousand mg/d increase in maternal potassium intake was associated with an average increase in offspring systolic blood pressure of 0.68 mm Hg (95% CI, 0.02-1.34) up to age 5 years (pooled), with significant associations only in girls (β=1.14 mm Hg [95% CI, 0.21-2.08]). No significant association was seen between maternal sodium intake and OBP.
Conclusions:
Elevated maternal 24-hour urine aldosterone and higher dietary potassium intake were associated with higher OBP but within normal range in young children, and girls were more susceptible to maternal potassium intake.
Registration:
URL: https://clinicaltrials.gov. Unique identifier: ID NCT02183558.
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