Maternal childhood cardiometabolic risk factors and pregnancy complications

Ann Epidemiol. 2017 Jul;27(7):429-434. doi: 10.1016/j.annepidem.2017.06.002. Epub 2017 Jun 29.

Abstract

Purpose: The influence of childhood health on later-life health outcomes is increasingly hypothesized but rarely tested. We examined the relationship between cardiometabolic indicators in childhood and risk of pregnancy-induced hypertension, preeclampsia, and gestational diabetes.

Methods: Childhood measurements from 755 women in the Bogalusa Heart Study included body mass index, systolic and diastolic blood pressure (SBP and DBP), low- and high-density lipoprotein cholesterol, total cholesterol, triglycerides, insulin, and glucose. Average childhood values were estimated by area under the curve computed from longitudinal quadratic random-effects growth models to account for the unequally spaced repeated measures. Women reported pregnancy complications, and medical records were linked to interview data where possible. Log-Poisson models predicted adjusted risk associated with an interquartile range increase in cardiometabolic indicators.

Results: Elevated childhood insulin was associated with 10%-15% increased risk across the three outcomes. Elevated childhood SBP was associated with preeclampsia (SBP RR = 1.50, 95% CI: 1.13, 2.01) and SBP, DBP, and body mass index predicted pregnancy-induced hypertension (SBP RR = 2.15, 95% CI: 1.65, 2.82; DBP RR = 1.83, 95% CI: 1.38, 2.43; BMI RR = 1.67, 95% CI: 1.41, 1.98). Blood pressure mediated the association between childhood body mass index and pregnancy-induced hypertension.

Conclusions: Results suggest the potential long-term impact of early-life cardiometabolic profiles on complications of pregnancy.

Keywords: Gestational diabetes; Preeclampsia; Pregnancy-induced hypertension.

MeSH terms

  • Adult
  • Black People
  • Blood Glucose
  • Blood Pressure / physiology
  • Diabetes, Gestational / epidemiology*
  • Female
  • Humans
  • Hypertension / epidemiology
  • Hypertension, Pregnancy-Induced / epidemiology*
  • Insulin / blood
  • Lipids / blood
  • Longitudinal Studies
  • Metabolic Syndrome / physiopathology*
  • Pre-Eclampsia / epidemiology*
  • Pregnancy
  • Pregnancy Complications / epidemiology*
  • Prospective Studies
  • Risk Factors
  • Triglycerides / blood
  • White People

Substances

  • Blood Glucose
  • Insulin
  • Lipids
  • Triglycerides