Blood pressure of 12-year-old children born after foetal growth restriction due to hypertensive disorders of pregnancy; relation to neonatal, life style, and family characteristics

Abstract

Introduction: Children born from pregnancies that were complicated by hypertensive disorders of pregnancy (HDP, i.e. pre-eclampsia or HELLP syndrome) are at risk for elevated systolic and diastolic blood pressure (SBP/DBP) in childhood.

Aim: To examine which neonatal, life style, and family characteristics are associated with SBP/DBP.

Methods: Study design: Prospective cohort.

Subjects: 12-years-old preterm and growth restricted children born to women with severe early-onset HDP.

Outcome measures: SBP/DBP standard deviation scores (SDS), corrected for age, gender and height.

Results: Ninety-two of the 174 mother-child pairs participated at age 12 years (mean gestational age 32 weeks, range 27 to 38 weeks, mean birth weight ratio (BWR) 0.68, range 0.33 to 0.99). Mean SBP SDS was 0.70 ± 0.81 and mean DBP SDS was 0.14 ± 0.78. SBP SDS was positively associated with very preterm birth (beta 0.53, p = .002), with child BMI SDS (beta 0.25, p = .035), and maternal BMI ≥ 25 kg/m² at 12 years (beta 0.49, p = .003), and not with pre-pregnancy maternal BMI ≥ 25 kg/m². DBP SDS was positively associated with maternal BMI ≥ 25 kg/m² (beta 0.35, p 0.002). BWR was not associated with blood pressure.

Conclusions: In 12-years old children born to women with HDP, higher systolic blood pressure values were associated with very preterm birth and child BMI. Higher blood pressure values were also associated with current maternal BMI ≥ 25 kg/m². Life style adaptations may benefit long-term cardio vascular health in mother and child.

Keywords: Blood pressure; Foetal growth restriction; Offspring; Pre-eclampsia; Risk factors.