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 heart health at a young age, scientists said Monday.
By age 12, these children are more likely to be overweight or to be diagnosed with high blood pressure, high cholesterol or high blood sugar, compared to children whose mothers had uncomplicated pregnancies.
Research highlights the strong link between healthy pregnancies and child health, although the study does not prove cause and effect. The findings also support the “fetal origins of adult disease” hypothesis, which suggests that many chronic conditions may be rooted in fetal adaptations to the womb environment.
The findings come from a government-backed study which followed an international group 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, Md. An abstract was published in a supplement to the American Journal of Obstetrics and Gynecology in January.
“It creates 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 themselves, they are already more likely to have more severe hypertension and diabetes in pregnancy. “said Dr. Kartik K. Venkatesh, the paper’s first author, an obstetrician and perinatal epidemiologist at Ohio State University Wexner Medical Center in Columbus.
The findings point to the urgency of preventive care and early intervention, both during pregnancy and early childhood, to stop the cycle, he added.
“The impact for children is decades from now, so the question is: What can we do here and now to maintain their cardiovascular health throughout their lives?” said Dr. Venkatesh.
“Can we detect abnormalities in cardiovascular health early so we can treat them and implement interventions that could change long-term outcomes?”
Women planning pregnancy also may 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 the chances of heart disease. Part of the reason: Women are putting off motherhood until later in life.
Of 3,317 pregnant women in the study, 263 (8 percent) developed pregnancy-related high blood pressure, 402 (12 percent) had gestational diabetes, and 82 (2.5 percent) were diagnosed with both conditions during pregnancy. duration of pregnancy.
By 12, those whose mothers had high blood pressure during pregnancy faced a 16 percent higher risk of developing heart problems, such as high cholesterol or being overweight, compared to those born to mothers without complications.
Children born to mothers with gestational diabetes were 11% more likely to have such a marker, the researchers found. And children of mothers with both conditions were nearly 20 percent more likely to have early signs of cardiovascular problems.
Dr. Rachel M. Bond, a cardiologist and system director of Women’s Heart Health at Dignity Health in Chandler, Ariz., said the findings were important and could lead to earlier screening and treatment of heart disease in children.
“I think this is really going to change pediatric guidelines and change the way we care for patients,” Dr. Bond said. “If your mother had an adverse pregnancy outcome, perhaps we should examine you earlier. We need to encourage people to know about their family medical history, including the complications their mothers had during pregnancy.”
Although there are no such guidelines yet, he added, “we are starting the conversation.”
Dr. Annette Ansong, associate chief of outpatient cardiology at Children’s National Hospital in Washington, said she had begun to incorporate questions about the mother’s pregnancy health when taking the medical histories of her young patients.
“I’ve started asking the patient’s parents, ‘When you were pregnant, did you have pre-eclampsia, hypertension or diabetes?’ I didn’t do that before, and I’m guessing the majority of doctors don’t,” said Dr. Ansong.
“With a family history, you’re pretty much focused on the parents, the aunts and uncles, the grandparents, and what we don’t usually ask is, ‘What was going on in the womb, inside mom’s belly?'” she added.
