title: Clinical cardiovascular risk during young adulthood in offspring of hypertensive pregnancies: insights from a 20-year prospective follow-up birth cohort.
abstract: OBJECTIVE
  Offspring of hypertensive pregnancies have increased cardiovascular risk factors during childhood. We hypothesised that offspring of hypertensive pregnancies would demonstrate increased clinical levels of hypertension by young adult life, which would be proportional to the severity of the pregnancy complication.
  
  
  METHODS
  Prospective birth cohort study
  
  
  METHODS
  Tertiary obstetric hospital.
  
  
  METHODS
  2868 young adult offspring of women enrolled during pregnancy into the Western Australia Pregnancy Cohort (Raine) Study.
  
  
  METHODS
  Cardiovascular risk, including incidence of hypertension and metabolic disease, in those born to hypertensive compared to normotensive pregnancies.
  
  
  RESULTS
  Young adult offspring of hypertensive pregnancies were 2.5 times (95% CI 1.32 to 4.56, p=0.004) more likely to have global lifetime risk (QRISK) scores above the 75th centile. Thirty per cent of 20 year olds with hypertensive blood pressures were born following a hypertensive pregnancy. Pre-eclampsia or hypertension resulting in preterm birth associated with a threefold (95% CI 1.3 to 7.0, p=0.01) greater risk of being hypertensive by age 20 years, with no differences in body mass index. Whereas pregnancy-induced hypertension associated with a smaller 3 ± 1 mm Hg blood pressure rise (p=0.001) and a twofold (95% CI 1.5 to 2.8, p=0.001) greater risk of being obese or overweight. Risk factor associations were consistent throughout early life and independent of other birth-factors.
  
  
  CONCLUSIONS
  Incidence of offspring hypertension was significantly increased in those whose mothers had a more complicated pregnancy history, including preterm birth and pre-eclampsia.
authors.affiliation: Oxford Cardiovascular Clinical Research Facility, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, Oxford, UK.
authors.forename: Esther F
authors.initials: EF
authors.lastname: Davis
authors.affiliation: Oxford Cardiovascular Clinical Research Facility, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, Oxford, UK.
authors.forename: Adam J
authors.initials: AJ
authors.lastname: Lewandowski
authors.affiliation: Oxford Cardiovascular Clinical Research Facility, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, Oxford, UK Nuffield Department of Obstetrics and Gynaecology, University of Oxford, Oxford, UK.
authors.forename: Christina
authors.initials: C
authors.lastname: Aye
authors.affiliation: Oxford Cardiovascular Clinical Research Facility, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, Oxford, UK.
authors.forename: Wilby
authors.initials: W
authors.lastname: Williamson
authors.affiliation: Oxford Cardiovascular Clinical Research Facility, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, Oxford, UK.
authors.forename: Henry
authors.initials: H
authors.lastname: Boardman
authors.affiliation: Telethon Kids Institute, Crawley, Western Australia, Australia.
authors.forename: Rae-Chi
authors.initials: RC
authors.lastname: Huang
authors.affiliation: School of Medicine and Pharmacology, Crawley, Western Australia, Australia.
authors.forename: Trevor A
authors.initials: TA
authors.lastname: Mori
authors.affiliation: School of Women's and Infants' Health, University of Western Australia, Crawley, Western Australia, Australia.
authors.forename: John
authors.initials: J
authors.lastname: Newnham
authors.affiliation: School of Medicine and Pharmacology, Crawley, Western Australia, Australia.
authors.forename: Lawrence J
authors.initials: LJ
authors.lastname: Beilin
authors.affiliation: Oxford Cardiovascular Clinical Research Facility, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, Oxford, UK.
authors.forename: Paul
authors.initials: P
authors.lastname: Leeson
mesh_terms: D000328:Adult; D004198:Disease Susceptibility; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension; D015994:Incidence; D007231:Infant, Newborn; D008297:Male; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000453:epidemiology / Q000235:genetics / Q000503:physiopathology*; D011297:Prenatal Exposure Delayed Effects / Q000453:epidemiology / Q000235:genetics / Q000503:physiopathology*; D011446:Prospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D014904:Western Australia / Q000453:epidemiology; D055815:Young Adult
keywords: EPIDEMIOLOGY; PUBLIC HEALTH