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Pregnancy-Associated Hypertension and Offspring Cardiometabolic Health

Rice, Madeline, Murguia, PhD; Landon, Mark, B., MD; Varner, Michael, W., MD; Casey, Brian, M., MD; Reddy, Uma, M., MD, MPH; Wapner, Ronald, J., MD; Rouse, Dwight, J., MD; Tita, Alan T., N., MD, PhD; Thorp, John, M., Jr, MD; Chien, Edward, K., MD, MBA; Saade, George, MD; Peaceman, Alan, M., MD; Blackwell, Sean, C., MD

doi: 10.1097/AOG.0000000000002433
Contents: Original Research

OBJECTIVE: To evaluate whether pregnancy-associated hypertension (gestational hypertension and preeclampsia) was associated with the cardiometabolic health of young offspring.

METHODS: This was a prospective observational follow-up study from 2012 to 2013 of children born to women previously enrolled in a mild gestational diabetes mellitus treatment trial or nongestational diabetes mellitus observational study. At 5–10 years after birth, children were examined and fasting blood samples obtained to determine the following cardiometabolic risk factors: blood pressure (BP), high-density lipoprotein cholesterol, triglycerides, glucose, homeostatic model assessment of insulin resistance, waist circumference, and body mass index (BMI).

RESULTS: This analysis included 979 children evaluated at a median 7 years of age. Twenty-three (2%) were born preterm from a hypertensive pregnancy, 73 (7%) were born at term from a hypertensive pregnancy, 58 (6%) were born preterm from a normotensive pregnancy, and 825 (84%) were born at term from a normotensive pregnancy (reference group). After adjusting for confounding factors, mean adjusted systolic BP was significantly higher in the children who were born at term to mothers who experienced pregnancy-associated hypertension compared with those born at term to normotensive mothers (systolic BP of 104 mm Hg, 95% CI 101–106 vs systolic BP of 99 mm Hg, 95% CI 99–100, P=.001). No other significant differences were observed.

CONCLUSION: Pregnancy-associated hypertension in women who deliver at term was associated with higher systolic BP in the offspring, but not with their measures of diastolic BP, BMI, waist circumference, homeostatic model assessment of insulin resistance, glucose, or lipids.

CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov, NCT00069576.

Pregnancy-associated hypertension in women who deliver at term is associated with higher systolic blood pressure in 5- to 10-year-old offspring.

George Washington University Biostatistics Center, Washington, DC; and the Departments of Obstetrics and Gynecology, The Ohio State University, Columbus, Ohio, University of Utah Health Sciences Center, Salt Lake City, Utah, University of Texas Southwestern Medical Center, Dallas, Texas, Columbia University, New York, New York, Brown University, Providence, Rhode Island, University of Alabama at Birmingham, Birmingham, Alabama, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, MetroHealth Medical Center–Case Western Reserve University, Cleveland, Ohio, University of Texas Medical Branch, Galveston, Texas, Northwestern University, Chicago, Illinois, and University of Texas Health Science Center at Houston–Children’s Memorial Hermann Hospital, Houston, Texas; and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland.

Corresponding author: Madeline Murguia Rice, PhD, Department of Epidemiology and Biostatistics, George Washington University Biostatistics Center, 6110 Executive Boulevard, Suite 750, Rockville, MD 20852; email: mrice@bsc.gwu.edu.

Supported by Grants from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) (HD27915, HD36801, HD34208, HD34116, HD40485, HD40500, HD27869, HD40560, HD40544, HD53097, HD40512, HD40545) and the National Institutes of Health's National Center for Advancing Translational Sciences (UL1TR001070, UL1TR000439). Comments and views of the authors do not necessarily represent views of the National Institutes of Health.

Dr. Rouse, Associate Editor of Obstetrics & Gynecology, was not involved in the review or decision to publish this article.

Financial Disclosure The authors did not report any potential conflicts of interest.

Presented in part at the 2016 Annual Scientific Meeting of the Society for Maternal-Fetal Medicine, February 1–6, 2016, Atlanta, Georgia.

* For a list of other members of the NICHD MFMU Network, see Appendix 1, available online at http://links.lww.com/AOG/B50.

The authors thank Francee Johnson, RN, BSN, and Lisa Moseley, RN, for protocol development and coordination between clinical research centers; Lindsay Doherty, MS, for protocol and data management and statistical analysis; and Elizabeth Thom, PhD, and Catherine Y. Spong, MD, for protocol development and oversight.

Each author has indicated that he or she has met the journal's requirements for authorship.

© 2018 by The American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.