麻豆传媒

Children born to mothers with obesity, a form of diabetes that develops during pregnancy (gestational diabetes mellitus) or high blood pressure during pregnancy have higher blood pressure — both the top and bottom numbers — than children born to mothers without these risk factors, according to a new study.

Among children whose mothers had at least one risk factor, blood pressure also rose more quickly between ages 2 and 18 compared to their peers. The findings, which suggest that blood pressure interventions could start as early as pregnancy, were published in .

This new study examined links and interactions between a mother’s cardiometabolic health during pregnancy and her child’s blood pressure up to age 18. The study included nearly 30 years of data from 12,480 mother-child pairs across the United States.

The findings can help shape prevention efforts on both ends of the equation, including lifestyle changes for women of childbearing age and earlier blood pressure screenings for at-risk children, says study first author Zhongzheng “Jason” Niu, assistant professor of epidemiology and environmental health at UB and a Presidential Sustainability Solutions Fellow at the University of Southern California. Shohreh Farzan, associate professor of population and public health sciences at the Keck School of Medicine at USC, is senior author.

Funded by the National Institutes of Health, researchers found that children born to mothers with at least one cardiometabolic risk factor had a systolic blood pressure (SBP — the top number) that averaged 4.88 percentile points higher than children whose mothers had no risk factors. Diastolic blood pressure (DBP — the bottom number) averaged 1.90 percentile points higher. Children born to mothers with one or more risk factors also had a faster increase in blood pressure between ages 2 and 18.

Nearly half of the mothers in the study had at least one cardiometabolic risk factor. Obesity was the most common, followed by high blood pressure disorders during pregnancy, including gestational hypertension, preeclampsia and other conditions, and gestational diabetes mellitus.

For children, researchers used blood pressure readings to calculate SBP and DBP percentiles, which estimate how a child’s blood pressure compares to that of peers who are the same age, sex and height.

Researchers conducted a statistical analysis to examine how maternal risk factors related to blood pressure in their offspring down the line, accounting for other variables that could influence the results, like maternal age or smoking during pregnancy.

At their first blood pressure reading, children born to mothers with any cardiometabolic risk factor ranked in a higher SBP percentile (4.88 points higher, on average) and DBP percentile (1.09 points higher, on average) than their peers born to mothers with no risk factors.

Children born to mothers with two risk factors faced even higher blood pressure. For example, when mothers had both obesity and a hypertensive disorder of pregnancy, their children had SBP that averaged 7.31 points higher and DBP that averaged 4.04 points higher than children whose mothers had no risk factors. The effects were more pronounced in female compared to male offspring, and in Black children compared to other racial and ethnic groups.

Across the country, heart health is declining, with high blood pressure affecting more people — and showing up earlier in life. Growing evidence indicates that blood pressure levels may be shaped by early development, even before birth. But most research on maternal and child heart health has looked at risk factors individually, rather than exploring their combined role.

The new study’s findings show that on top of directly benefiting women, better cardiovascular health during the childbearing years can also support health in the next generation, Niu explains. Earlier blood pressure screenings for children — even those who are healthy by other measures — could also help identify candidates for intervention before problems arise.

“Currently, most clinical guidelines do not suggest blood pressure screenings for children who seem healthy overall,” Niu says. “But our evidence is clear, showing that even a small blood pressure difference in early life can magnify over a longer period.”