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Hypertensive disorders of pregnancy and later cardiovascular disease risk in mothers and children

Published online by Cambridge University Press:  15 October 2020

Michelle D. Plummer Open the ORCID record for Michelle D. Plummer [Opens in a new window] ,
Prabha H. Andraweera Open the ORCID record for Prabha H. Andraweera [Opens in a new window] ,
Amy Garrett ,
Shalem Leemaqz ,
Melanie Wittwer ,
Emily Aldridge ,
Margaret A. Arstall ,
Gustaaf A. Dekker  and
Claire T. Roberts
Michelle D. Plummer
Affiliation:
Robinson Research Institute, University of Adelaide, Adelaide, South Australia, Australia Adelaide Medical School, University of Adelaide, Adelaide, South Australia, Australia
Prabha H. Andraweera
Affiliation:
Robinson Research Institute, University of Adelaide, Adelaide, South Australia, Australia Adelaide Medical School, University of Adelaide, Adelaide, South Australia, Australia
Amy Garrett
Affiliation:
Robinson Research Institute, University of Adelaide, Adelaide, South Australia, Australia Adelaide Medical School, University of Adelaide, Adelaide, South Australia, Australia
Shalem Leemaqz
Affiliation:
Robinson Research Institute, University of Adelaide, Adelaide, South Australia, Australia Adelaide Medical School, University of Adelaide, Adelaide, South Australia, Australia Flinders Health and Medical Research Institute, Flinders University, Bedford Park, South Australia, Australia
Melanie Wittwer
Affiliation:
Robinson Research Institute, University of Adelaide, Adelaide, South Australia, Australia Adelaide Medical School, University of Adelaide, Adelaide, South Australia, Australia Department of Cardiology, Lyell McEwin Hospital, Elizabeth Vale, South Australia, Australia
Emily Aldridge
Affiliation:
Robinson Research Institute, University of Adelaide, Adelaide, South Australia, Australia Adelaide Medical School, University of Adelaide, Adelaide, South Australia, Australia Department of Cardiology, Lyell McEwin Hospital, Elizabeth Vale, South Australia, Australia
Margaret A. Arstall
Affiliation:
Adelaide Medical School, University of Adelaide, Adelaide, South Australia, Australia Department of Cardiology, Lyell McEwin Hospital, Elizabeth Vale, South Australia, Australia
Gustaaf A. Dekker
Affiliation:
Robinson Research Institute, University of Adelaide, Adelaide, South Australia, Australia Adelaide Medical School, University of Adelaide, Adelaide, South Australia, Australia Division of Women’s Health, Lyell McEwin Hospital, Elizabeth Vale, South Australia, Australia
Claire T. Roberts*
Affiliation:
Robinson Research Institute, University of Adelaide, Adelaide, South Australia, Australia Adelaide Medical School, University of Adelaide, Adelaide, South Australia, Australia Flinders Health and Medical Research Institute, Flinders University, Bedford Park, South Australia, Australia
*
Address for correspondence: Claire T. Roberts, Flinders Health and Medical Research Institute, Flinders University, Bedford Park, South Australia5042, Australia. Email: claire.roberts@flinders.edu.au
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Abstract

Preeclampsia (PE) and gestational hypertension (GH) are pregnancy-specific diseases that occur in around 10% of pregnancies worldwide. Increasing evidence suggests that women whose pregnancies were complicated by PE or GH, and their offspring, are at increased risk of cardiovascular disease (CVD) later in life. We hypothesised that PE and GH would associate with CVD risk factors 8–10 years after the first pregnancy in the mother and child and that differences in cardiovascular risk profile would be seen between 8- and 10-year-old male and female children. This is a follow-up study of the Adelaide SCOPE pregnancy cohort where 1164 nulliparous women and their babies were recruited between 2005 and 2008. Haemodynamic function was assessed using non-invasive USCOMBP+ and USCOM1A devices. Microvascular function was assessed by post-occlusive reactive hyperaemia. Of the 273 mother–child pairs followed up, 38 women had PE and 20 had GH during pregnancy. Augmentation index (Aix) and suprasystolic pulse pressure (ssPP) were increased, whereas measures of microvascular function were decreased in children who were born to PE compared to uncomplicated pregnancies. Female children had decreased Aix and ssPP compared to male children after in utero exposure to PE. Women who developed GH during their first pregnancy had increased systolic, diastolic and mean arterial pressures compared to women who had uncomplicated pregnancy. Our data suggest that GH is associated with increased cardiovascular risk in women 8–10 years after first pregnancy and PE is associated with increased offspring risk at 8–10 years of age, highlighting differences between these two hypertensive disorders of pregnancy.

Keywords

Hypertensive disorders of pregnancycardiovascular riskchildrenmotherssexual dimorphism
Type
Original Article
Information
Journal of Developmental Origins of Health and Disease , Volume 12 , Issue 4 , August 2021 , pp. 555 - 560
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Copyright
© The Author(s), 2020. Published by Cambridge University Press in association with International Society for Developmental Origins of Health and Disease

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