A study published in JAMA Network Open provides evidence that complications during pregnancy can influence the cardiovascular health of offspring in early adulthood. The research tracked over 1,300 mother-child pairs for more than 20 years.
Key Details
- The study focused on three adverse pregnancy outcomes (APOs): hypertensive disorders (e.g., preeclampsia, gestational hypertension), gestational diabetes, and preterm birth (delivery before 37 weeks). These conditions affect nearly one in four pregnancies in the US.
- Data came from the Future of Families and Child Well Being Study (1998-2000), conducted across 20 US cities, including many low-income and minority participants.
- When children reached age 22, researchers measured blood pressure, blood samples (HbA1c), and carotid artery thickness via ultrasound.
Findings
Hypertensive disorders showed the strongest association with later health. Exposed young adults had higher BMI, higher diastolic blood pressure, higher HbA1c, and thicker carotid artery walls (0.02 mm difference, corresponding to several years of extra vascular aging).
- Gestational diabetes: Associated with weaker cardiovascular health scores and thicker artery walls. The link weakened when analyzing only normal-weight babies, suggesting fetal overgrowth may play a role.
- Preterm birth: Associated with higher HbA1c, but no significant early artery damage at age 22.
Statements
Dr. Nilay Shah (senior author, Northwestern University Feinberg School of Medicine): "We must make sure people maintain good health from childhood into young adulthood, so that if or when someone becomes a parent, they pass on the best opportunity for good health to their children."
Shah noted that both parents' health at conception and during pregnancy influences child health. The researchers stated the study shows strong associations but cannot prove cause and effect.
Background
The concept that early development affects lifelong health, known as Developmental Origins of Health and Disease, originated from David Barker's 1980s observation linking low birth weight to higher heart disease risk.
Limitations
- The study cannot establish causality. Other factors such as genetics, inflammation, and gene expression may contribute.
Broader Implications
- Heart disease may begin before birth. However, most heart disease is preventable through health behaviors later in life.
- Managing blood pressure and blood sugar during pregnancy may reduce long-term risks for offspring.
- Shah advises parents to pay attention to children's health behaviors and consult pediatricians.