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High BP during pregnancy increases childhood obesity risk
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Elevated maternal blood pressure during the second and third trimesters of pregnancy — among both normotensive and hypertensive women — is positively associated with the risk for childhood overweight and obesity in offspring, according to findings reported in The Journal of Clinical Endocrinology & Metabolism.
“Our study is the first to demonstrate that among pregnant women, elevated blood pressure is associated with a greater risk for overweight and obesity for their children,” Ju-Sheng Zheng, PhD, of Qingdao University in Qingdao, China, and the University of Cambridge in Cambridge, United Kingdom, said in a press release. “The risk still existed for children of women who didn’t have hypertension, but whose blood pressure during pregnancy was at the high end of the normal range.”
In a prospective study, Zheng and colleagues analyzed data from 88,406 mother-child pairs from the Jiaxing Birth Cohort, a study of mother-child pairs enrolled between 1999 and 2013 living in a region of southeast China with follow-up of children until age 6 to 7 years (mean maternal age at birth, 25 years; mean maternal BMI, 20.5 kg/m²). Maternal BP was measured during each trimester of pregnancy; hypertension was defined as diastolic BP of at least 99 mm Hg and/or systolic BP of at least 140 mm Hg. Body weight and height of children were measured at each follow-up visit; childhood overweight and obesity were defined according to cutoffs established by the International Obesity Task Force. Researchers used logistic regression analysis to examine odds of offspring overweight or obesity per 10 mm Hg increase in maternal BP during the first, second and third trimester.
During pregnancy, mean maternal systolic BP increased from 105.9 mm Hg in the first trimester to 108.7 mm Hg in the second trimester to 115.2 mm Hg in the third trimester; mean diastolic BP increased from 68.4 mm Hg in the first trimester to 69.1 mm Hg in the second trimester to 75.3 mm Hg in the third trimester.
Among children followed at age 4 to 7 years (mean age, 5.9 years), 6.6% had overweight and 2.5% had obesity.
Among normotensive women, second and third trimester systolic and diastolic BP were positively associated with offspring overweight and obesity risk at age 4 to 7 years. For each 10-mm Hg rise in maternal systolic and diastolic BP in the second trimester, ORs were 1.05 (95% CI, 1.01-1.09) and 1.08 (95% CI, 1.05-1.11), respectively. For each 10-mm Hg rise in maternal systolic and diastolic BP in the third trimester, ORs were 1.05 (95% CI, 1.01-1.1) and 1.06 (95% CI, 1.03-1.09), respectively. Results persisted after adjustment for maternal characteristics, including age, menarcheal age, parity, corresponding BP at previous trimesters, maternal BMI and height.
Among both normotensive and hypertensive women, maternal hypertension in the second trimester was associated with 49% greater risk for offspring overweight and obesity (95% CI, 1.18-1.89), whereas maternal hypertension in the third trimester increased the risk for childhood overweight or obesity by 14% (95% CI, 1.05-1.25), according to researchers.
For normotensive and hypertensive women, associations between maternal BP and offspring overweight or obesity risk appeared to be linear or J-shaped, the researchers noted.
“All pregnant women should monitor their blood pressure and try to limit a substantial increase in mid-to-late pregnancy,” Dou Li, PhD, chief professor of nutrition at the Institute of Nutrition and Health at Qingdao University, China, told Endocrine Today. “This may help reduce the obesity risk of their children.” – by Regina Schaffer
Disclosures: The authors report no relevant financial disclosures.
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