Study Finds Link Between Prenatal Cardiometabolic Factors and Hypertension for Children
By protecting pregnant patients from cardiometabolic risk factors, healthier blood pressure can be promoted for children.
Prenatal cardiometabolic risk factors can correlate to unfavorable outcomes for children, according to results of a study published in JAMA Network Open. By protecting pregnant patients from cardiometabolic risk factors, healthier blood pressure can be promoted for children.1
By protecting pregnant patients from cardiometabolic risk factors, healthier blood pressure can be promoted for children. | Image Credit: stock28studio - stock.adobe.com
“Our findings suggest there are important opportunities to reduce childhood obesity, such as helping pregnant women quit smoking and manage healthy weight gain, as well as closely monitoring children who show early signs of rapid weight gain,” Chang Liu, PhD, of Washington State University, said in a news release.2 “The fact that we can identify unusual BMI [body mass index] patterns as early as age 3.5 shows how critical early childhood is for preventing obesity.”
High blood pressure in childhood is associated with an increased risk of cardiovascular diseases, according to the study authors. “Preventing high blood pressure in childhood, therefore, is a promising target to improve cardiovascular health across the life course. However, risk factors for high blood pressure in early life remain poorly understood, and growing evidence has associated them with an adverse intrauterine environment,” they said.1
Investigators used data from the Environmental Influences on Child Health Outcomes program to examine the 3 most common maternal cardiometabolic risk factors with children’s blood pressures. They further investigated whether the child’s sex, race, and ethnicity would have an effect on maternal cardiometabolic risk factors and blood pressure.1
The overall population included 12,480 mothers with a mean age of 29 years. Approximately 7% were Asian, 15.5% were black, 18.7% were Hispanic, 52.3% were White, and 5.8% were another race and ethnicity. Approximately 44.4% of mothers had 1 maternal cardiometabolic risk factor, with prepregnancy obesity being the most common (24.6%), followed by hypertensive disorder of pregnancy (13.6%) and gestational diabetes (6.5%). They found the children born to mothers with any risk factor had higher sex-, age-, and height-adjusted systolic blood pressure and dystolic blood pressure percentiles compared with their counterparts without risk factors. After adjusting for confounders, the differences remained statistically significant.1
Hypertensive disorder of pregnancy alone or in combination with another risk factor was also associated with higher blood pressure. For systolic blood pressure, the largest difference was for mothers with both hypertensive disorder or pregnancy and prepregnancy obesity, followed by a combination of hypertensive disorder of pregnancy and gestational diabetes. For diastolic, a combination of hypertensive disorder of pregnancy and gestational diabetes followed by a combination of hypertensive disorder of pregnancy and prepregnancy obesity was associated with the largest differences. Gestational diabetes alone was not associated with diastolic blood pressure.1
For sex, the association for diastolic blood pressure was more pronounced for females compared with males, but systolic blood pressure associations were comparable between both males and females. As for race and ethnicity, the associations were more pronounced for Black children for systolic blood pressure with gestational diabetes and hypertensive disorder of pregnancy. The association between prepregnancy obesity and systolic blood pressure was greater for White children, followed by Black children and Asian children. For all combinations of risk factors, the systolic blood pressure percentiles were highest for Black children, excluding prepregnancy obesity alone, which was highest for Asian children.2
“Our findings have important public health implications. In the face of declining generational cardiovascular health in the overall US population, our results suggest that crucial next steps should include escalating interventions to prevent obesity and enhanced screening and treatment of gestational diabetes and HDP [hypertensive disorder of pregnancy] in childbearing populations,” the study authors said.2 “Because we have identified an amplified association with offspring blood pressure changes over time by maternal cardiometabolic risk factors and clear evidence on the sequelae of higher childhood blood pressure on cardiovascular disease risk later in life, targeted screening should be prioritized for young children born to mothers with obesity, gestational diabetes, or HDP [hypertensive disorder of pregnancy].”
READ MORE: Pediatrics Resource Center
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