Women who develop high blood pressure or diabetes during pregnancy are more likely to give birth to children who develop conditions that can compromise their own heart health at a young age, scientists reported Monday.
By age 12, these children are more likely to be overweight or diagnosed with high blood pressure, high cholesterol, or high blood sugar, compared to children whose mothers had uncomplicated pregnancies.
The research highlights the strong association between healthy pregnancies and child health, although the study stops short of demonstrating a cause-and-effect relationship. The findings also support the “fetal origins of adult diseases” hypothesis, which suggests that many chronic diseases may have their roots in fetal adaptations to the uterine environment.
The findings come from a government-backed study that has followed an international cohort of 3,300 mother-child pairs for more than a decade. The research was presented at the Society for Maternal-Fetal Medicine’s annual pregnancy meeting in National Harbor, Maryland. A summary was published. in a supplement to the American Journal of Obstetrics and Gynecology in January.
“This sets up a potentially vicious cycle for children, where the child is at higher risk for cardiovascular disease, and then when these girls become women and become pregnant, they are already more likely to have more severe hypertension and diabetes during the child’s life.” pregnancy.,” said Dr. Kartik K. Venkatesh, first author of the paper, an obstetrician and perinatal epidemiologist at The Ohio State University Wexner Medical Center in Columbus.
The findings indicate the urgency of preventative care and early intervention, both during pregnancy and early childhood, to stop the cycle, he added.
“The impact for children will be decades from now, so the question is: What can we do here and now to preserve their cardiovascular health throughout their lives?” Dr. Venkatesh said.
“Can we detect abnormalities in cardiovascular health early on, so we can treat them and implement interventions that could change long-term outcomes?”
Women who are planning a pregnancy can also benefit from seeking care even before they conceive, she added. More women are entering pregnancies with conditions (such as obesity, high blood pressure, and diabetes) that increase their chances of developing heart disease. Part of the reason is that women are postponing motherhood until later in their lives.
Of 3,317 pregnant women in the study, 263 (8 percent) developed pregnancy-related high blood pressure, 402 (12 percent) developed gestational diabetes, and 82 (2.5 percent) were diagnosed with both conditions during pregnancy.
By age 12, those whose mothers had high blood pressure during pregnancy faced a 16 percent higher risk of having an indicator of heart problems, such as high cholesterol or being overweight, compared to those born to mothers without complications.
The researchers found that children born to mothers with gestational diabetes were 11 percent more likely to have that indicator. And children of mothers with both conditions were almost 20 percent more likely to have an early sign of cardiovascular problems.
Dr. Rachel M. Bond, a cardiologist and director of the Women’s Heart Health system at Dignity Health in Chandler, Arizona, said the findings were significant and could lead to earlier detection and treatment of heart disease in children.
“I think this will really change pediatric guidelines and change the way we care for patients,” Dr. Bond said. “If her mother had an adverse outcome during pregnancy, perhaps we should screen her earlier. “We need to encourage people to know their family medical history, including any complications their mothers had during pregnancy.”
Although no such guidelines exist yet, he added, “we are starting the conversation.”
Dr. Annette Ansong, associate chief of outpatient cardiology at Nationwide Children’s Hospital in Washington, D.C., said she had begun incorporating questions about maternal pregnancy health when taking the medical history of her young patients.
“I started asking the patient’s parents: ‘When you were pregnant, did you have preeclampsia, hypertension or diabetes?’ I didn’t do that before and I guess most doctors don’t,” Dr. Ansong said.
“With family history, you’re pretty much focused on parents, aunts and uncles, grandparents, and what we don’t typically ask is, ‘What was going on in the womb, inside mom’s womb?'” she added.