High Blood Pressure During Pregnancy Predisposes Children to Heart Disease and Stroke Risk

Highlights:

• Gestational hypertensive disorders increase the chances of heart disease and stroke in children
• Children who were born to moms with hypertensive pregnancy disorders had 29% and 33% increased risks of heart disease, and stroke
• Shared genetic or environmental factors and direct intrauterine effects could owe to the risk of heart disease and stroke respectively

Maternal hypertensive disorders could predispose children to ischemic heart disease and stroke, says finding of the study presented at the online scientific conference of the European Society of Cardiology (ESC) Heart & Stroke, 2021. "Our findings indicate that hypertensive disorders during pregnancy are associated with increased risks of stroke and potentially heart disease in offspring up to the age of 41 years," said study author Dr. Fen Yang, PhD student, Karolinska Institutet, Stockholm, Sweden.

The study participants were national registers from two countries: Sweden and Finland. Until 2014, 5.8 million live singleton births from both the countries (From 1973 and 1987 for Sweden and Finland) were observed for ischemic heart disease and stroke. The participant mothers who were previously diagnosed with high blood pressure, and pre-eclampsia gave birth to 218,322 children.

The factors that could potentially impact the relationship between hypertensive pregnancy disorders of the mother to the risk of heart disease and stroke in her offspring were taken as the confounding factors for adjustment.

The major factors considered were child's year of birth, sex, and congenital anomalies and the mother's age, parity, marital status, education level, body mass index, smoking during early pregnancy, and family history of cardiovascular disease.

All these analyses were repeated once again after excluding children who had born prematurely or those who had fetal growth restriction. To evaluate the possible effects of unmeasured genetic and environmental familial factors, sibling analyses that included even the sibling pairs discordant for both the exposure (hypertensive pregnancy disorders) and the outcome (ischemic heart disease /stroke) were performed.

Impact of Maternal Hypertensive Disorders

During the follow-up period (up to 41 years), 2,340 (0.04%) and 5,360 (0.09%) were diagnosed with ischemic heart disease and stroke. The offspring of mothers who had hypertensive pregnancy disorders had 29% and 33% increased risks of ischemic heart disease, and stroke, respectively, despite the factors like preterm birth and fetal growth restriction.

This link remained for stroke but not for ischemic heart disease in the sibling analyses. With the help of outcomes from sibling analyses, researchers identified that shared genetic or environmental factors were the main contributors for the association between gestational hypertensive disorders and the risk of ischemic heart disease, although the persistence of risk for stroke suggested the possibility of direct intrauterine effects.

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Dr. Yang concluded: "This was one of very few studies in this area and more research is needed. It was an observational study, and we cannot make any conclusions about causality. If our findings are supported by further studies, steps could be taken to prevent cardiovascular disease in offspring exposed to hypertensive pregnancy disorders - for example by focussing on maternal health and screening children for risk factors like high blood pressure early in life."

Ways to Prevent Hypertension During Pregnancy

• Reduce the amount of salt intake
• Exercise regularly
• Get enough amount of rest
• Cut down of caffeinated products and alcohol

Source-Medindia