title: Preeclampsia and gestational hypertension are associated with childhood blood pressure independently of family adiposity measures: the Avon Longitudinal Study of Parents and Children.
abstract: BACKGROUND
  Offspring of women with hypertensive disorders of pregnancy are at increased risk of cardiovascular complications later in life, but the mechanisms underlying these associations are unclear. Our aim was to examine whether adjusting for birth weight and familial adiposity changed the association of hypertensive disorders of pregnancy with offspring blood pressure.
  
  
  RESULTS
  Using data from 6343 nine-year-old participants in the Avon Longitudinal Study of Parents and Children, we examined the association between hypertensive disorders of pregnancy (preeclampsia and gestational hypertension) and offspring blood pressure. Both preeclampsia and gestational hypertension were associated with systolic and diastolic blood pressures in the 9-year-old offspring; after adjustment for parental and own adiposity and for other potential confounders, the mean difference in systolic blood pressure was 2.05 mm Hg (95 confidence interval, 0.72 to 3.38) and 2.04 mm Hg (95 confidence interval, 1.42 to 2.67) for preeclampsia and gestational hypertension, respectively, compared with those with no hypertensive disorders of pregnancy. Equivalent results for diastolic blood pressure were 1.00 mm Hg (95 confidence interval, -0.01 to 2.10) and 1.07 mm Hg (95 confidence interval, 0.60 to 1.54). The association of preeclampsia with offspring systolic and diastolic blood pressures attenuated toward the null with further adjustment for birth weight and gestational age, whereas these adjustments did not attenuate the association of gestational hypertension with offspring blood pressure.
  
  
  CONCLUSIONS
  The associations of hypertensive disorders of pregnancy with higher offspring blood pressure are not explained by familial adiposity. The mechanisms linking preeclampsia and gestational hypertension with offspring blood pressure may differ, with the former mediated at least in part by the effect of preeclampsia on intrauterine growth restriction.
authors.affiliation: Generation R Study Group and Departments of Epidemiology and Pediatrics, Erasmus Medical Center, Rotterdam, the Netherlands.
authors.forename: J J Miranda
authors.initials: JJ
authors.lastname: Geelhoed
authors.forename: Abigail
authors.initials: A
authors.lastname: Fraser
authors.forename: Kate
authors.initials: K
authors.lastname: Tilling
authors.forename: Li
authors.initials: L
authors.lastname: Benfield
authors.forename: George
authors.initials: G
authors.lastname: Davey Smith
authors.forename: Naveed
authors.initials: N
authors.lastname: Sattar
authors.forename: Scott M
authors.initials: SM
authors.lastname: Nelson
authors.forename: Debbie A
authors.initials: DA
authors.lastname: Lawlor
mesh_terms: D050154:Adiposity / Q000502:physiology*; D000328:Adult; D001724:Birth Weight; D001794:Blood Pressure / Q000502:physiology*; D015992:Body Mass Index; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology; D046110:Hypertension, Pregnancy-Induced / Q000503:physiopathology*; D015994:Incidence; D008137:Longitudinal Studies; D008297:Male; D015999:Multivariate Analysis; D011225:Pre-Eclampsia / Q000503:physiopathology*; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects / Q000503:physiopathology*; D012727:Sex Characteristics
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