Hypertension in Pregnancy and Offspring Cardiovascular Risk in Young Adulthood

Abstract

H ypertensive disorders of pregnancy include gestational hypertension and preeclampsia.1 In addition to hypertension, preeclampsia is characterized by proteinuria and is a leading cause of maternal and perinatal morbidity. [2][3][4] It is well established that women with a history of hypertension in pregnancy are at increased risk of cardiovascular disease (CVD) later in life, [5][6][7][8] and their offspring may also have an increased lifetime risk of CVD.9-11 Children and adolescents whose mothers had preeclampsia seem to have higher body mass index (BMI) and blood pressure than others, but it is not entirely clear whether other cardiovascular risk factors, such as serum lipids, may also differ.12 Also, it remains to be determined whether siblings born after a hypertensive pregnancy differ in their cardiovascular profile compared with siblings born after a normotensive pregnancy. Such an analysis might help clarify whether the children's risk factors could be attributed to the hypertensive pregnancy or whether shared genes or shared lifestyle are equally relevant.Using a prospective cohort design, we investigated whether intrauterine exposure to maternal hypertensive disorders (gestational hypertension, term preeclampsia, or preterm preeclampsia) is associated with cardiovascular risk factors Abstract-Women with hypertensive disorders in pregnancy are at increased lifetime risk for cardiovascular disease. We examined the offspring's cardiovascular risk profile in young adulthood and their siblings' cardiovascular risk profile. From the HUNT study (Nord-Trøndelag Health Study) in Norway, 15 778 participants (mean age: 29 years), including 210 sibling groups, were linked to information from the Medical Birth Registry of Norway. Blood pressure, anthropometry, serum lipids, and C-reactive protein were assessed. Seven hundred and six participants were born after exposure to maternal hypertension in pregnancy: 336 mothers had gestational hypertension, 343 had term preeclampsia, and 27 had preterm preeclampsia. Offspring whose mothers had hypertension in pregnancy had 2.7 (95% confidence interval, 1.8-3.5) mm Hg higher systolic blood pressure, 1.5 (0.9-2.1) mm Hg higher diastolic blood pressure, 0.66 (0.31-1.01) kg/m 2 higher body mass index, and 1.49 (0.65-2.33) cm wider waist circumference, compared with offspring of normotensive pregnancies. Similar differences were observed for gestational hypertension and term preeclampsia. Term preeclampsia was also associated with higher concentrations of non-high-density lipoprotein cholesterol (0.14 mmol/L, 0.03-0.25) and triglycerides (0.13 mmol/L, 0.06-0.21). Siblings born after a normotensive pregnancy had nearly identical risk factor levels as siblings born after maternal hypertension. Offspring born after maternal hypertension in pregnancy have a more adverse cardiovascular risk profile in young adulthood than offspring of normotensive pregnancies. Their siblings, born after a normotensive pregnancy, have a similar risk profile, suggesting that shared genes or lifestyle...

MicroRNA-218-5p Promotes Endovascular Trophoblast Differentiation and Spiral Artery Remodeling

“…3,4 Furthermore, numerous studies report that babies born to PE mothers have a significantly greater risk of developing cardiovascular diseases later in life. 5,6 The pathogenesis of PE is not well understood; however, it is recognized that the placenta is the origin. A successful pregnancy depends on healthy function of the placenta, which requires the precise and coordinated differentiation of cytotrophoblast cells (CTBs) into interstitial extravillous trophoblasts (iEVTs) that invade the decidua.…”

The Complement System and Preeclampsia

“…Preeclampsia affects 3–4% of pregnancies and is a major cause of preterm birth with its adverse consequences [3]. In addition, problems persist after pregnancy as the risk of adverse cardiovascular events in mother and in offspring of preeclamptic pregnancies is increased [4–6]. Preeclampsia is historically known as a multisystem disorder manifested by onset of high blood pressure in the second half of pregnancy with proteinuria.…”

Association of preeclampsia with anthropometric measures and blood pressure in Indian children

“…Taller height or accelerated childhood height gain have also been reported, though less consistently [8,14]. Several studies and two systematic reviews [10,15] have also found that offspring born to mothers with preeclampsia exhibit higher systolic and diastolic blood pressure as children, adolescents and adults [9,11,12,16,17,18,19,20,21]. Sex specific changes, and differences in effects depending on whether preeclampsia was mild, moderate or severe, have been described in some of these studies.…”

“…Previous studies in high income countries (HICs), have investigated the effects of maternal PE on height, weight, body mass index (BMI), other measures of adiposity, and blood pressure among children or adults. These have shown that preeclampsia is associated with higher weight and body mass index in adolescents and adults [8,9,10,11,12,13]. Taller height or accelerated childhood height gain have also been reported, though less consistently [8,14].…”