Pregnancy Health Affects Child's Long-Term Blood Pressure

Medscape

19-05-2025

Children of mothers with hypertension, diabetes, or obesity had systolic and diastolic blood pressure readings that were 4.88 and 1.90 percentile points higher, respectively, than those of children whose mothers did not have these conditions.
METHODOLOGY:
Researchers analyzed data from a program monitoring environmental influences on child health outcomes and examined three common maternal cardiometabolic risk factors during pregnancy: Prepregnancy obesity, gestational diabetes, and hypertensive disorders of pregnancy.
The analysis included over 30 years of data starting from 1994; a total of 12,480 mother-offspring pairs were included, 44.4% of which had a risk factor.
Women had a mean maternal age of 29.9 years; 52.3% were White, 18.7% were Hispanic, 15.5% were Black, 7% were Asian, and 5.8% identified as being of another race or ethnicity.
Information about the mother's heart health, blood pressure, and weight was collected from medical records and questionnaires.
Researchers measured the systolic and diastolic blood pressures of each infant, adjusting for age, sex, and height.
TAKEAWAY:
In all, 5537 of the mothers had at least one heart or metabolic health issue, the most common being obesity before pregnancy (24.6%), high blood pressure during pregnancy (13.6%), and gestational diabetes (6.5%).
Children born to mothers with any cardiometabolic risk factor showed higher systolic blood pressure (95% CI, 3.97-5.82) and higher diastolic blood pressure (95% CI, 1.15-2.64) at first measurement than those born to mothers without any risk factors.
Among 6015 children with multiple blood pressure measurements, those whose mothers had cardiometabolic risk factors experienced larger increases in blood pressure from ages 2 to 18 years, with systolic pressure increasing by 0.2-0.8 percentiles each year and diastolic pressure increasing by 0.5-1.0 percentiles each year.
IN PRACTICE:
'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 disorders of pregnancy] in childbearing populations,' the researchers reported. 'Such a move might not only protect mothers from long-term cardiovascular disease risk themselves but also shift the population distribution toward healthier endpoints in the next generations,' they added.
SOURCE:
This study was led by Zhongzheng Niu, PhD, of the Keck School of Medicine at the University of Southern California in Los Angeles. It was published online on May 8 in JAMA Network Open .
LIMITATIONS:
The researchers grouped pregnancy-related problems associated with high blood pressure, although different subtypes may affect a child's blood pressure in various ways. Body mass index was used to estimate body fat but was noted to be an imperfect measure. This study did not have details on how much weight mothers gained during pregnancy, their diet, or how active they were.
DISCLOSURES:
One or more study authors reported receiving grants from the National Institutes of Health, the Centers for Disease Control and Prevention, and Eli Lilly and personal fees from the American Thoracic Society; the National Heart, Lung, and Blood Institute; the Parker B. Francis Council of Scientific Advisors; and Pfizer.