Obstetrician-assessed maternal health at pregnancy predicts offspring future health.
BACKGROUND
We aimed to examine the association between obstetrician assessment of maternal physical health at the time of pregnancy and offspring cardiovascular disease risk.


RESULTS
We examined this association in a birth cohort of 11,106 individuals, with 245,000 person years of follow-up. We were concerned that any associations might be explained by residual confounding, particularly by family socioeconomic position. In order to explore this we used multivariable regression models in which we adjusted for a range of indicators of socioeconomic position and we explored the specificity of the association. Specificity of association was explored by examining associations with other health related outcomes. Maternal physical health was associated with cardiovascular disease: adjusted (socioeconomic position, complications of pregnancy, birthweight and childhood growth at mean age 5) hazard ratio comparing those described as having poor or very poor health at the time of pregnancy to those with good or very good health was 1.55 (95%CI: 1.05, 2.28) for coronary heart disease, 1.91 (95%CI: 0.99, 3.67) for stroke and 1.57 (95%CI: 1.13, 2.18) for either coronary heart disease or stroke. However, this association was not specific. There were strong associations for other outcomes that are known to be related to socioeconomic position (3.61 (95%CI: 1.04, 12.55) for lung cancer and 1.28 (95%CI:1.03, 1.58) for unintentional injury), but not for breast cancer (1.10 (95%CI:0.48, 2.53)).


CONCLUSIONS
These findings demonstrate that a simple assessment of physical health (based on the appearance of eyes, skin, hair and teeth) of mothers at the time of pregnancy is a strong indicator of the future health risk of their offspring for common conditions that are associated with poor socioeconomic position and unhealthy behaviours. They do not support a specific biological link between maternal health across her life course and future risk of cardiovascular disease in her offspring.
MRC Centre for Causal Analyses in Translational Epidemiology, Department of Social Medicine, University of Bristol, United Kingdom. d.a.lawlor@bristol.ac.uk
Debbie A
DA
Lawlor
Susan
S
Morton
G David
GD
Batty
Sally
S
Macintyre
Heather
H
Clark
George Davey
GD
Smith
D000328:Adult; D002318:Cardiovascular Diseases / Q000453:epidemiology; D002648:Child; D002669:Child Welfare / Q000706:statistics & numerical data*; D015331:Cohort Studies; D005260:Female; D020073:Gravidity; D006801:Humans; D008297:Male; D008423:Maternal Age; D008429:Maternal Welfare / Q000706:statistics & numerical data*; D009774:Obstetrics / Q000379:methods*; D010290:Parents; D011237:Predictive Value of Tests; D011247:Pregnancy; D012307:Risk Factors; D012606:Scotland; D012680:Sensitivity and Specificity; D012923:Social Class; D055815:Young Adult