Heart-healthy pregnancy improves future CV health in children
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PHILADELPHIA — A new study highlights an independent association between maternal CV health during the third trimester and subsequent offspring CV health at 10 to 14 years of age.
Using a CV health scoring system that assessed BMI, BP, total cholesterol, fasting blood glucose and smoking status — five metrics from the AHA’s Life’s Simple 7 — researchers found that every 1-point increase in maternal gestational CV health score was associated with a 0.24 (95% CI; 0.14-0.34) point higher offspring CV health score, according to data presented at the American Heart Association Scientific Sessions.
Offspring were scored using the same system apart from smoking status.
Moreover, compared with offspring of mothers with high-scoring maternal gestational CV health, offspring of mothers with moderate-to-low gestational CV health had lower scores by 0.55 (95% CI, 0.33-0.77) and 2.06 (95% CI, 1.10-3.03) points, respectively, according to the data.
In other findings, mean maternal gestational CV health score was 7.8 out of 10; and considered high in 64.4%, moderate in 34.2% and low in 1.4% of mothers. Mean offspring CV health score was 6.8 out of 8 and considered high in 64.4%, moderate in 33.4% and low in 2.2% of children, according to the results.
“These findings set the stage for a move toward proactively measuring and modifying maternal CV health during pregnancy using the comprehensive CV health framework, as opposed to passively monitoring for single indicators of severe cardiometabolic dysfunction, such as preeclampsia,” Amanda M. Perak, MD, MS, assistant professor of pediatrics and preventive medicine at Northwestern University and pediatric cardiologist at Ann & Robert H. Lurie Children’s Hospital of Chicago, told Healio. “Clinically, the CV health construct provides a unified message about the mother's health level across a spectrum. In 2018, the American Heart Association and American College of Obstetrics and Gynecology published a joint advisory encouraging collaboration between cardiologists and OB/Gyns to care for women's cardiovascular health. They identified pregnancy as an opportunity to identify and intervene upon cardiovascular risk, and they encouraged use of the CV health construct across the life course. However, maternal CV health in pregnancy had not previously been studied as a potential determinant of child CV health.”
In this observational study using data from the Hyperglycemia and Adverse Pregnancy Outcome Follow Up Study, researchers analyzed 877 mother-child dyads from field centers in the U.S., Barbados, U.K., Thailand, China and Canada. According to the study, mothers were examined at mean 28 weeks gestation and at follow-up 10 to 14 years later alongside their offspring. CV health scores were classified as high (mother 8-10, child 7-8), moderate (mother 5-7, child 4-6) or low (mother 0-4, child 0-3).
“The take-home message is that ideal CV health, which has been extensively studied and determined to be a powerful predictor of healthy longevity in nonpregnant adults, also appears to be relevant in pregnancy for the health of the offspring,” Perak told Healio.
Additional analyses will examine the association of individual maternal CV health metrics with the CV health of children to test the hypothesis that each metric adds value to the CV health construct as a whole, she said. Further research on the role of maternal CV health in advance pregnancy outcomes, using data from the Hyperglycemia and Adverse Pregnancy Outcome Follow Up Study cohort is also planned. – by Scott Buzby
Reference:
Perak AM, et al. Presentation MDP454. Development of Cardiovascular Disease Across the Lifetime. Presented at: American Heart Association Scientific Sessions; Nov. 16-18, 2019; Philadelphia.
Disclosures: Perak reports she received the NHLBI K23 Career Development Award, Northwestern University Dixon Translational Research Grant and Northwestern Memorial Hospital Eleanor Wood-Prince Grant. Please see the full study for the other author’s relevant financial disclosures.
Perspective
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C. Noel Bairey Merz, MD, FACC, FAHA, FESC
This study reinforces that fast-food consumption and maternal nutrition when pregnant is related to baby-child obesity and CV health. These findings could be confounded by family eating patterns rather than in utero exposure on its own. This research reiterates that adult women and men should consider Mediterranean-style diet and nutrition for not only their own health, but for the health of their children as well. Physicians should not blame mothers for everything.
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