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

Abstract

Women who had hypertensive disorders in pregnancy have an increased risk of cardiovascular diseases in later life. No studies, however, have investigated whether maternal hypertensive disorders in pregnancy affect self-measured blood pressure at home (HBP) in mothers and their children. We evaluated the association between maternal hypertension during pregnancy and HBP based on the prospective Tohoku Study of Child Development birth cohort study, which was performed in two areas in Japan. We included children in a singleton birth at term (36-42 weeks of gestation) with a birth weight of >2400 g. We collected prenatal care data from the medical charts. Because only two mothers experienced preeclampsia, we defined gestational hypertension (GH) as a hypertensive disorder in pregnancy. Seven years after birth, mothers and their children measured their HBP in the morning for 2 weeks. Of 813 eligible mothers, 28 (3.4%) experienced GH, and those were of a similar age compared with 785 non-GH mothers (37.3 vs. 38.0 years; P=0.41). Women with GH had higher body mass index (BMI) (23.8 vs. 21.4 kg m(-)(2); P=0.01) and elevated HBP (120.3/76.8 vs. 110.4/68.6 mm Hg; P<0.0002) 7 years after delivery. However, HBP was similar in children with and without GH mothers (93.5/55.9 vs. 94.1/56.1 mm Hg, P>0.38). These results were confirmatory in case-control (1:2) analyses with matching by maternal age, maternal BMI before pregnancy, survey area and parity. In conclusion, maternal GH did not affect HBP in offspring but strongly affected maternal HBP even 7 years after birth.

Hypertensive disorders during pregnancy and elevated blood pressure in the offspring

“…Furthermore, in some studies, no elevated BP was observed in the offspring born in mothers with any types of HDP. [29] In addition, the cardiovascular effects of offspring after intrauterine exposure to HDP were demonstrated by 2 reviews recently. [30,31] Unfortunately, not all studies were included and HDP was not categorized to different types for further analysis.…”

Perspectives acquired through long-term epidemiological studies on the Great East Japan Earthquake

“…Maternal gestational hypertension did not affect home blood pressure in offspring, but it did strongly affect maternal home blood pressure, even 7 years after giving birth [ 22 ]. Home blood pressure among children with 7 years of age who received long-term (mean, 11.3 months) breastfeeding as a major source of nutrition was significantly lower than that among children who received short-term (mean, 5.1 months) breastfeeding (92.9/55.1 versus 94.7/56.4 mm Hg systolic/diastolic blood pressure, respectively; p = 0.006/0.04), suggesting that long-term breastfeeding had a protective effect against elevated blood pressure even in young children [ 23 ].…”

Importance of follow-up after delivery in women who experience hypertensive disorders during pregnancy

“…In contrast, gestational hypertension has not been associated with these factors. In the article by Hosaka et al 9 , a large proportion of the women with hypertensive pregnancy disorders had gestational hypertension. There were no significant differences in birth weight and gestational age between women with gestational hypertension and non-hypertensive pregnancy disorders.…”

“…In this issue of the journal, Hosaka et al 9 present the blood pressure levels for a mother and her offspring 7 years after delivery and compare the blood pressure levels between HBPM and clinical measurements. The main conclusion from this study is that hypertensive pregnancy disorders are closely correlated to a mother's elevated blood pressure later in life but have no influence on her offspring at 7 years of age.…”