Maternal Cardiometabolic Risk Factors in Pregnancy and Offspring Blood Pressure at Age 2 to 18 Years
- PMID: 40338548
- PMCID: PMC12062903
- DOI: 10.1001/jamanetworkopen.2025.9205
Maternal Cardiometabolic Risk Factors in Pregnancy and Offspring Blood Pressure at Age 2 to 18 Years
Abstract
Importance: Higher blood pressure in early life may signal cardiovascular disease over the life course, but determinants of blood pressure in early life are poorly understood.
Objective: To examine the association of maternal cardiometabolic risk factors during pregnancy with offspring blood pressure from age 2 to 18 years and explore whether the association is modified by offspring sex and race and ethnicity.
Design, setting, and participants: This cohort study analyzed data from the Environmental Influences on Child Health Outcomes program between January 1, 1994, and March 31, 2023. Three common maternal cardiometabolic risk factors during pregnancy were examined: prepregnancy obesity, gestational diabetes, and hypertensive disorders of pregnancy (HDP).
Exposure: Maternal cardiometabolic risk factors were retrieved and harmonized from medical records and questionnaires.
Main outcomes and measures: Offspring systolic blood pressure (SBP) and diastolic blood pressure (DBP) percentiles adjusted for age, sex, and height were calculated.
Results: Among 12 480 mother-offspring pairs (mean [SD] maternal age during pregnancy, 29.9 [6.4] years; 856 of 12 303 identifying as Asian [7.0%]; 1908 as Black [15.5%]; 2305 as Hispanic [18.7%]; 6522 as White [52.3%], and 712 as other [5.8%] race and ethnicity), at least 1 maternal cardiometabolic risk factor was present in 5537 (44.4%), with prepregnancy obesity being the most prevalent (3072 [24.6%]), followed by HDP (1693 [13.6%]) and gestational diabetes (805 [6.5%]). Offspring born to mothers with any cardiometabolic risk factors had higher SBP (4.88 percentile points; 95% CI, 3.97-5.82 percentile points) and higher DBP (1.90 percentile points; 95% CI, 1.15-2.64 percentile points) at their first blood pressure measurement, after adjusting for potential confounders, compared with their counterparts without any risk factors. Hypertensive disorders of pregnancy, alone or with either prepregnancy obesity or gestational diabetes, was significantly associated with higher offspring blood pressure. These associations were generally more significant among female compared with male offspring and among Black compared with other racial and ethnic groups. Among 6015 offspring who had 2 or more blood pressure measures, maternal cardiometabolic risk factors were associated with an increased rate of blood pressure change from age 2 to 18 years (SBP percentile, 0.5 [95% CI, 0.2-0.8] per year; DBP percentile, 0.7 [95% CI 0.5-1.0] per year).
Conclusions and relevance: These findings suggest that protecting pregnant individuals from cardiometabolic risk factors may promote healthier blood pressure in the next generation.
Conflict of interest statement
Figures
Comment in
- doi: 10.1001/jamanetworkopen.2025.9214
References
Publication types
MeSH terms
Grants and funding
- UG3 OD035542/OD/NIH HHS/United States
- UH3 OD023275/OD/NIH HHS/United States
- UH3 OD023249/OD/NIH HHS/United States
- UH3 OD023286/OD/NIH HHS/United States
- UG3 OD035529/OD/NIH HHS/United States
- UG3 OD035513/OD/NIH HHS/United States
- UH3 OD023332/OD/NIH HHS/United States
- U2C OD023375/OD/NIH HHS/United States
- UG3 OD035533/OD/NIH HHS/United States
- UH3 OD023253/OD/NIH HHS/United States
- UH3 OD023349/OD/NIH HHS/United States
- UH3 OD023285/OD/NIH HHS/United States
- UG3 OD035526/OD/NIH HHS/United States
- UG3 OD035508/OD/NIH HHS/United States
- UH3 OD023248/OD/NIH HHS/United States
- UG3 OD035537/OD/NIH HHS/United States
- UH3 OD023287/OD/NIH HHS/United States
- UH3 OD023365/OD/NIH HHS/United States
- UH3 OD023288/OD/NIH HHS/United States
- UH3 OD023337/OD/NIH HHS/United States
- UH3 OD023251/OD/NIH HHS/United States
- UG3 OD035540/OD/NIH HHS/United States
- U24 OD023382/OD/NIH HHS/United States
- UH3 OD023389/OD/NIH HHS/United States
- U2C ES026542/ES/NIEHS NIH HHS/United States
- UG3 OD035518/OD/NIH HHS/United States
- UH3 OD023320/OD/NIH HHS/United States
- UH3 OD023305/OD/NIH HHS/United States
- UG3 OD035519/OD/NIH HHS/United States
- K23 DK131289/DK/NIDDK NIH HHS/United States
- UG3 OD035517/OD/NIH HHS/United States
- UG3 OD035528/OD/NIH HHS/United States
- UH3 OD023272/OD/NIH HHS/United States
- U2C ES030851/ES/NIEHS NIH HHS/United States
- UG3 OD035509/OD/NIH HHS/United States
- UH3 OD023290/OD/NIH HHS/United States
- UH3 OD023342/OD/NIH HHS/United States
- UG3 OD035543/OD/NIH HHS/United States
- UG3 OD035532/OD/NIH HHS/United States
- U2C ES026555/ES/NIEHS NIH HHS/United States
- UG3 OD035550/OD/NIH HHS/United States
- UH3 OD023318/OD/NIH HHS/United States
- UH3 OD023347/OD/NIH HHS/United States
- U24 OD035523/OD/NIH HHS/United States
- UG3 OD035546/OD/NIH HHS/United States
- UG3 OD035521/OD/NIH HHS/United States
- U2C ES026561/ES/NIEHS NIH HHS/United States
- UH3 OD023279/OD/NIH HHS/United States
- UH3 OD023348/OD/NIH HHS/United States
- UH3 OD023268/OD/NIH HHS/United States
- UG3 OD035536/OD/NIH HHS/United States
- UG3 OD035527/OD/NIH HHS/United States
- UH3 OD023282/OD/NIH HHS/United States
- U2C ES030857/ES/NIEHS NIH HHS/United States
- L30 DK130155/DK/NIDDK NIH HHS/United States
- UH3 OD023271/OD/NIH HHS/United States
- UG3 OD035544/OD/NIH HHS/United States
- UH3 OD023244/OD/NIH HHS/United States
- U2C ES030859/ES/NIEHS NIH HHS/United States
- UH3 OD023328/OD/NIH HHS/United States
- U2C ES026533/ES/NIEHS NIH HHS/United States
- UH3 OD023289/OD/NIH HHS/United States
- U24 OD023319/OD/NIH HHS/United States
- UH3 OD023313/OD/NIH HHS/United States
- UH3 OD023344/OD/NIH HHS/United States
- UG3 OD035516/OD/NIH HHS/United States
- U24 ES026539/ES/NIEHS NIH HHS/United States
LinkOut - more resources
Full Text Sources
Medical
