Does hypertensive disorder of pregnancy predict offspring blood pressure at 21 years? Evidence from a birth cohort study

Abstract

Although few studies found that the offspring of women who experienced preeclampsia have higher blood pressure (BP) at childhood and adolescence, no study has observed whether this association exists for adult offspring. To examine whether maternal hypertensive disorder of pregnancy (HDP) predicts adult offspring BP. We followed a sub-sample of 2608 mother-offspring pairs for 21 years from an original cohort of 7223 singleton infants whose mothers gave birth in Brisbane, Australia between 1981 and 1983. HDP was defined as diastolic BP (DBP) over 90 mm Hg on at least two occasions beyond 20 weeks gestation associated with proteinuria and/or excessive fluid retention. Adult offspring's systolic BP (SBP) and DBP were measured at 21 years. Multivariable regressions were used to examine the independent associations of HDP with offspring BP. Unadjusted regression analysis showed that offspring of women who experienced HDP have 3.46 mm Hg greater SBP and 3.02 mm Hg greater DBP at 21 years. This association remained consistent after adjusting for potential confounding and mediating factors including offspring gender, age, percentile birth weight for gestation, placenta weight and body mass index (BMI) at 21 year, maternal age, education, racial origin, and smoking during pregnancy and their pre-pregnancy BMI. Findings of this study suggest that maternal HDP predicts adult offspring BP. Keywords: hypertensive disorder of pregnancy; offspring blood pressure; young adults IntroductionWomen who develop hypertensive disorder of pregnancy (HDP) or preeclampsia are at an increased risk for high blood pressure (BP) and cardiovascular diseases later in life. 1 Also, men and women born after preeclampsia in pregnancies are likely to trigger severe preeclampsia in their own (or their partner's) pregnancy. 2 Recently, it has been observed that children exposed to preeclampsia are at an increased risk of a variety of diseases including endocrine, nutritional and metabolic diseases. 3 A recent study by Kajantie et al. 4 using the Helsinki Birth Cohort Study found that preeclampsia was associated with increased risk of stroke and severe preeclampsia was associated with hypertension in an adult offspring 60-70 years after their birth. Several other studies also reported that the offspring of women who developed preeclampsia have higher BP in childhood 5-7 and adolescence. [8][9][10][11] A recent meta-analysis also found that offspring of women with preeclampsia had higher levels of BP as compared with offspring from uneventful pregnancies. 12 Most of the studies have reported findings in children and adolescents but not in adults. Some studies have not adjusted for potential confounding or mediating factors such as maternal pre-pregnancy body mass index (BMI) 10 and maternal smoking during pregnancy. 8,11 It is unclear whether the observed associations are spurious or confounded with these factors. Using a long follow-up of a birth cohort study, we have the capacity to examine whether this association between HDP and offspring BP remai...

Relationship between maternal gestational hypertension and home blood pressure in 7-year-old children and their mothers: Tohoku Study of Child Development

“…15 CBP in the Avon Longitudinal Study of Parents and Children was significantly higher in 17-year-old offspring of mothers with GH (120.5 ± 11.3/66.0 ± 7.2-mm Hg) or preeclampsia (120.2 ± 10.1/66.6 ± 7.0 mm Hg) compared with non-PIH (117.6 ± 10.4/64.5 ± 6.8 mm Hg) even when adjusting for potential confounding factors in multivariable linear regression analysis. 15 Inconsistent with earlier studies, 15,31 including the Avon Longitudinal Study of Parents and Children, there were no significant associations between maternal GH and HBP in children at 7 years old in the present study. These findings were confirmatory when the 1:2 matched-case analyses were performed.…”

Preeclampsia as a Form of Type 5 Cardiorenal Syndrome: An Underrecognized Entity in Women’s Cardiovascular Health

“…In 2,868 young adult offspring of women enrolled during pregnancy into the Western Australia Pregnancy Cohort Study, offspring of hypertensive pregnancies were 2.5 times (95% CI 1.32-4.56, p = 0.004) more likely to have global lifetime risk scores above the 75th centile. Preeclampsia or hypertension resulting in preterm birth was associated with a 3-fold (95% CI 1.3-7.0, p = 0.01) greater risk of being hypertensive by age 20 years, with no differences in BMI [52,53].…”

“…Offspring of women with preeclampsia had a higher systolic blood pressure by 2.04 mm Hg (95% CI 1.33-2.76) and a higher diastolic blood pressure by 1.10 mm Hg (95% CI 0.47-1.73) in analyses adjusted for maternal and offspring BMI, offspring dietary sodium intake, and other potential confounders [54]. The Helsinki Birth Cohort Study observed that the offspring of preeclamptic pregnancies had almost double the lifetime risk of stroke (HR 1.9, 95% CI 1.2-3.0; p = 0.01) [52,55].…”

Prenatal Testosterone Induces Sex-Specific Dysfunction in Endothelium-Dependent Relaxation Pathways in Adult Male and Female Rats1

“…Moreover, epidemiological studies show that offspring born to pregnant polycystic ovary syndrome or preeclamptic mothers, who have elevated testosterone (T) levels [10][11][12][13][14], are more likely to have increased BP during postnatal life [15][16][17][18]. We have recently shown that the increases in BP in prenatal T-exposed adults were more pronounced in males than in females [6].…”