Preeclampsia and Gestational Hypertension Are Associated With Childhood Blood Pressure Independently of Family Adiposity Measures

Geelhoed, J.J. Miranda; Fraser, Abigail; Tilling, Kate; Benfield, L.; Smith, George Davey; Sattar, Naveed; Nelson, Scott M.; Lawlor, Debbie A.

doi:10.1161/circulationaha.110.936674

Cited by 191 publications

(197 citation statements)

References 30 publications

(38 reference statements)

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“…A large Finnish study suggested that offspring born after preeclampsia may be at higher risk of stroke later in life but found no association with coronary heart disease. [10][11][12][22][23][24][25][26] In a systematic review, including >45 000 participants, Davis et al 12 reported positive associations of preeclampsia with offspring blood pressure (systolic and diastolic) and BMI that were similar to ours. It has also been suggested that the higher childhood blood pressure associated with maternal hypertension in pregnancy may Values are shown as mean differences (95% CI) compared with offspring born after a normotensive pregnancy.…”

Section: Discussionsupporting

confidence: 80%

Hypertension in Pregnancy and Offspring Cardiovascular Risk in Young Adulthood

et al. 2017

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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...

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Section: Discussionsupporting

confidence: 80%

Hypertension in Pregnancy and Offspring Cardiovascular Risk in Young Adulthood

et al. 2017

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“…The observed effects were also not mediated by pregnancy complications, birth characteristics, or infant growth, which are all identified risk factors related to both maternal prepregnancy BMI and health of offspring. [38][39][40][41] Thus, our findings suggest that associations of maternal prepregnancy BMI with offspring cardiometabolic health outcomes may, at least partly, be explained by direct intrauterine mechanisms. This may include higher maternal plasma concentrations and placental transfer of glucose, amino acids, and free fatty acids during pregnancy, which may influence programming of offspring adiposity and an adverse cardiometabolic profile in later life.…”

Section: Interpretation Of Main Findingsmentioning

confidence: 63%

Childhood Cardiometabolic Outcomes of Maternal Obesity During Pregnancy

et al. 2014

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Maternal obesity during pregnancy is associated with an adverse cardiometabolic risk profile in childhood and adulthood. [1][2][3][4] The mechanisms underlying these associations might involve increased placental transfer of nutrients during fetal development, which may cause permanent adaptations in appetite, energy metabolism, and neuroendocrine function in offspring, which predispose individuals to a greater risk of cardiometabolic disease in later life. 5 However, these associations might also reflect shared family-based, lifestyle-related characteristics or genetic factors. 5 Comparing the strength of associations of prepregnancy body mass index (BMI) from both mother and father with childhood outcomes could help in disentangling underlying mechanisms. 6,7 Stronger associations for maternal BMI suggest direct intrauterine mechanisms, whereas similar or stronger associations for paternal BMI suggest a role for shared family-based, lifestyle-related characteristics or genetic factors. To date, studies comparing associations of maternal and paternal BMI with childhood BMI have shown conflicting results. 5,[8][9][10][11] Also, most previous studies did not explore associations of parental BMI with detailed childhood body and abdominal fat distribution and cardiometabolic outcomes. It further remains unclear whether differences in magnitude of associations of parental BMI with childhood outcomes are present across the full range of BMI or confined to parental obesity only.Therefore, in a population-based prospective cohort study among 4871 children and their parents, we examined the associations of maternal and paternal prepregnancy BMI with childhood BMI, total body and abdominal fat distribution, and cardiometabolic risk factors. We also explored whether these associations are present across the full range of BMI and explained by pregnancy, birth, or childhood characteristics.Abstract-Maternal prepregnancy obesity is associated with impaired cardiometabolic health in offspring. Whether these associations reflect direct intrauterine causal mechanisms remains unclear. In a population-based prospective cohort study among 4871 mothers, fathers, and their children, we examined the associations of both maternal and paternal prepregnancy body mass index (BMI) with childhood body fat distribution and cardiometabolic outcomes and explored whether any association was explained by pregnancy, birth, and childhood factors. We measured childhood BMI, total body and abdominal fat distribution, blood pressure, and blood levels of lipids, insulin, and C-peptide at the age of 6 years. We observed that higher maternal and paternal prepregnancy BMI were associated with higher childhood BMI, total body and abdominal fat mass measures, systolic blood pressure, and insulin levels and lower high-density lipoprotein cholesterol levels (P<0.05). Stronger associations were present for maternal than paternal BMI, with statistical support for heterogeneity between these associations. The associations for childhood fat mass and cardiometab...

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“…This is especially relevant as women with a hypertensive disorder of pregnancy give often birth to small for gestational age infants, who themselves have a higher risk of later cardiovascular disease. 40,41 Women gain on average 2 kg of weight after each pregnancy, and this is even more after a hypertensive disorder of pregnancy. 42,43 Interpregnancy weight gain is associated with a doubled risk of gestational hypertension, gestational diabetes mellitus, or preeclampsia during the next pregnancy.…”

Section: December 2012mentioning

confidence: 99%