title: The association between maternal blood pressures and offspring size at birth in Southeast Asian women.
abstract: BACKGROUND
  Maternal blood pressures in pregnancy is an important determinant of offspring size at birth. However, the relationship between maternal blood pressures and offspring's size at birth is not consistent and may vary between ethnic groups. We examined the relationship between maternal peripheral and central blood pressures and offspring size at birth in an Asian multi-ethnic cohort, and effect modifications by maternal ethnicity and obesity.
  
  
  METHODS
  We used data from 713 participants in the Growing Up in Singapore Towards Healthy Outcomes study consisting of pregnant Chinese, Malay and Indian women recruited from two tertiary hospitals between 2009 to 2010. Peripheral systolic and diastolic blood pressures (SBP and DBP), and central SBP and pulse pressure (PP) were measured around 27 weeks of gestation. Biometric parameters at birth were collected from medical records.
  
  
  RESULTS
  After adjusting for maternal and fetal covariates, each 1-SD increase (10.0 mmHg) in central SBP was inversely associated with birth weight (-40.52 g; 95% confidence interval (CI) -70.66 to -10.37), birth length (-0.19 cm; -0.36 to -0.03), head circumference (-0.12 cm; -0.23 to -0.02) and placental weight (-11.16 g; -20.85 to -1.47). A one-SD (11.1 mmHg) increase in peripheral SBP was also associated with lower birth weight (-35.56 g; -66.57 to -4.54). The inverse relations between other blood pressure measures and offspring size at birth were observed but not statistically significant. Higher peripheral SBP and DBP and central SBP were associated with increased odds of low birth weight (defined as weight <2500 g) and small for gestational age (defined as <10(th) percentile for gestational age adjusted birth weight). Maternal adiposity modified these associations, with stronger inverse associations in normal weight women. No significant interactions were found with ethnicity.
  
  
  CONCLUSIONS
  Higher second-trimester peripheral and central systolic pressures were associated with smaller offspring size at birth, particularly in normal weight women. Findings from this study reinforces the clinical relevance of antenatal blood pressure monitoring.
authors.affiliation: Saw Swee Hock School of Public Health, National University of Singapore, Block MD1, #11-01E, 12 Science Drive 2, Singapore, 117549, Republic of Singapore. pauletteyee@gmail.com.|KK Women's and Children's Hospital, 100 Bukit Timah Road, Singapore, 229899, Singapore. pauletteyee@gmail.com.
authors.forename: Wai-Yee
authors.initials: WY
authors.lastname: Lim
authors.affiliation: Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, 1E Kent Ridge Road, NUHS Tower Block Level 12, Singapore, 119228, Singapore. paeleeys@nus.edu.sg.|Singapore Institute for Clinical Sciences, A*STAR, Brenner Centre for Molecular Medicine, 30 Medical Drive, Singapore, 117609, Singapore. paeleeys@nus.edu.sg.
authors.forename: Yung-Seng
authors.initials: YS
authors.lastname: Lee
authors.affiliation: Saw Swee Hock School of Public Health, National University of Singapore, Block MD1, #11-01E, 12 Science Drive 2, Singapore, 117549, Republic of Singapore. chuen_seng_tan@nuhs.edu.sg.
authors.forename: Chuen-Seng
authors.initials: CS
authors.lastname: Tan
authors.affiliation: KK Women's and Children's Hospital, 100 Bukit Timah Road, Singapore, 229899, Singapore. kenneth.kwek.yc@kkh.com.sg.|Yong Loo Lin School of Medicine, National University of Singapore, 10 Medical Drive (MD6), Singapore, 117597, Singapore. kenneth.kwek.yc@kkh.com.sg.
authors.forename: Kenneth
authors.initials: K
authors.lastname: Kwek
authors.affiliation: Singapore Institute for Clinical Sciences, A*STAR, Brenner Centre for Molecular Medicine, 30 Medical Drive, Singapore, 117609, Singapore. obgcys@nus.edu.sg.|Yong Loo Lin School of Medicine, National University of Singapore, 10 Medical Drive (MD6), Singapore, 117597, Singapore. obgcys@nus.edu.sg.|Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, 1E Kent Ridge Road, NUHS Tower Block Level 12, Singapore, 119228, Singapore. obgcys@nus.edu.sg.
authors.forename: Yap-Seng
authors.initials: YS
authors.lastname: Chong
authors.affiliation: Singapore Institute for Clinical Sciences, A*STAR, Brenner Centre for Molecular Medicine, 30 Medical Drive, Singapore, 117609, Singapore. pd.gluckman@auckland.ac.nz.|Liggins Institute, The University of Auckland, Private Bag 92019, Victoria Street West, Auckland, 1142, New Zealand. pd.gluckman@auckland.ac.nz.
authors.forename: Peter D
authors.initials: PD
authors.lastname: Gluckman
authors.affiliation: MRC Lifecourse Epidemiology Unit (University of Southampton), Southampton General Hospital, Mailpoint 95, Southampton, SO16 6YD, UK. kmg@mrc.soton.ac.uk.|NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, SO16 6YD, UK. kmg@mrc.soton.ac.uk.
authors.forename: Keith M
authors.initials: KM
authors.lastname: Godfrey
authors.affiliation: Saw Swee Hock School of Public Health, National University of Singapore, Block MD1, #11-01E, 12 Science Drive 2, Singapore, 117549, Republic of Singapore. seang_mei_saw@nuhs.edu.sg.|Yong Loo Lin School of Medicine, National University of Singapore, 10 Medical Drive (MD6), Singapore, 117597, Singapore. seang_mei_saw@nuhs.edu.sg.
authors.forename: Seang-Mei
authors.initials: SM
authors.lastname: Saw
authors.affiliation: Saw Swee Hock School of Public Health, National University of Singapore, Block MD1, #11-01E, 12 Science Drive 2, Singapore, 117549, Republic of Singapore. ephanp@nus.edu.sg.|Yong Loo Lin School of Medicine, National University of Singapore, 10 Medical Drive (MD6), Singapore, 117597, Singapore. ephanp@nus.edu.sg.
authors.forename: An
authors.initials: A
authors.lastname: Pan
mesh_terms: D000293:Adolescent; D000328:Adult; D044466:Asian People; D001724:Birth Weight; D001794:Blood Pressure; D015992:Body Mass Index; D005260:Female; D005865:Gestational Age; D006801:Humans; D008875:Middle Aged; D009765:Obesity / Q000503:physiopathology*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000208:ethnology*; D011262:Pregnancy Trimester, Second; D037841:Pregnant People / Q000208:ethnology*; D012307:Risk Factors; D055815:Young Adult