title: Maternal Blood Pressure During Pregnancy and Early Childhood Blood Pressures in the Offspring: The GUSTO Birth Cohort Study.
abstract: Although epidemiological studies suggest that offspring of women with preeclampsia are at increased risk to higher blood pressures and cardiovascular disease, little is known about the nature of blood pressures between the mother and her offspring. As blood pressures comprise of both pulsatile (systolic blood pressure [SBP] and pulse pressure [PP]) and stable (diastolic blood pressure [DBP]) components, and they differ between central and peripheral sites, we sought to examine maternal peripheral and central blood pressure components in relation to offspring early childhood blood pressures. A prospective birth cohort of 567 Chinese, Malay, and Indian mother-offspring with complete blood pressure information were studied. Maternal brachial artery SBP, DBP, and PP were measured at 26 to 28 weeks gestation; and central SBP and PP were estimated from radial artery waveforms. Offspring brachial artery SBP, DBP, and PP were measured at 3 years of age. Associations between continuous variables of maternal blood pressures (peripheral SBP, DBP, PP, central SBP, and PP) and offspring blood pressures (peripheral SBP, DBP, and PP) were examined using multiple linear regression with adjustment for maternal characteristics (age, education level, parity, smoking status, alcohol consumption and physical activity during pregnancy, and pre-pregnancy BMI) and offspring characteristics (sex, ethnicity, BMI, and height at 3 years of age). In the multivariate models, offspring peripheral SBP increased by 0.08 (95% confidence interval 0.00-0.17, P = 0.06) mmHg with every 1-mmHg increase in maternal central SBP, and offspring peripheral PP increased by 0.10 (0.01-0.18, P = 0.03) mmHg for every 1-mmHg increase in maternal central PP. The relations of maternal-offspring peripheral blood pressures (SBP, DBP, and PP) were positive but not statistically significant, and the corresponding values were 0.05 (-0.03 to 0.13; P = 0.21), 0.03 (-0.04 to 0.10; P = 0.35), and 0.05 (-0.02 to 0.13; P = 0.14), respectively. Maternal central pulsatile blood pressure components (SBP and PP) during pregnancy are associated with higher blood pressures in the offspring. This positive correlation is already evident at 3-years old. Studies are needed to further evaluate the effects of maternal central pulsatile blood pressure components during pregnancy and long-term cardiovascular health in the offspring.
authors.affiliation: From the Saw Swee Hock School of Public Health, National University of Singapore and National University Health System (WYL, SSM), KK Women's and Children's Hospital (WYL, FKPY, NL, KK), Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (ASTAR) (YSL, IMA, MM, PDG, YSC), Clinical Nutrition Research Centre, Singapore Institute for Clinical Sciences, ASTAR and National University Health System (YSL, PDG, YSC), Department of Paediatrics, Yong Loo Lin School of Medicine (YSL), Yong Loo Lin School of Medicine, National University of Singapore and National University Health System (YSL, FKPY, KK, YSC, SSM), Duke-NUS Graduate Medical School, National University of Singapore, Singapore (FKPY, NL, KK), Ludmer Centre for Neuroinformatics and Mental Health University Institute (MM), Sackler Program for Epigenetics and Psychobiology, McGill University, Canada (MM), Liggins Institute, University of Auckland, Auckland, New Zealand (PDG), Human Development and Health Academic Unit, Faculty of Medicine, University of Southampton (KMG), NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust (KMG), Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK (KMG), Department of Obstetrics and Gynecology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore (YSC), and School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China (AP).
authors.forename: Wai-Yee
authors.initials: WY
authors.lastname: Lim
authors.forename: Yung-Seng
authors.initials: YS
authors.lastname: Lee
authors.forename: Fabian Kok-Peng
authors.initials: FK
authors.lastname: Yap
authors.forename: Izzudin Mohd
authors.initials: IM
authors.lastname: Aris
authors.forename: Ngee
authors.initials: N
authors.lastname: Lek
authors.forename: Michael
authors.initials: M
authors.lastname: Meaney
authors.forename: Peter D
authors.initials: PD
authors.lastname: Gluckman
authors.forename: Keith M
authors.initials: KM
authors.lastname: Godfrey
authors.forename: Kenneth
authors.initials: K
authors.lastname: Kwek
authors.forename: Yap-Seng
authors.initials: YS
authors.lastname: Chong
authors.forename: Seang-Mei
authors.initials: SM
authors.lastname: Saw
authors.forename: An
authors.initials: A
authors.lastname: Pan
mesh_terms: D000328:Adult; D044466:Asian People; D001794:Blood Pressure; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007194:India / Q000208:ethnology; D008297:Male; D011247:Pregnancy / Q000502:physiology*; D011446:Prospective Studies