Children born to mothers with pregnancy complications have higher heart risks

Women who develop high blood pressure or diabetes during pregnancy are more likely to have children who develop conditions at a young age that could jeopardize the health of their own hearts, scientists reported Monday.

By the time they are 12 years old, 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 pregnancies without complications.

The study underlines the strong link between healthy pregnancies and children's health, although the study cannot prove a cause-and-effect relationship. The conclusions also provide support for the 'fetal origins of adult disease' hypothesis, which suggests that many chronic conditions may have their origins in fetal adaptations to the uterine environment.

The findings come from a government-backed study that followed an international cohort of 3,300 mother-and-child pairs for more than a decade. The research was presented at the annual pregnancy meeting of the Society for Maternal Fetal Medicine in National Harbor, Maryland. A summary has been published in a supplement to the American Journal of Obstetrics and Gynecology in January.

“It creates a potentially vicious cycle for the children, where the child is at greater risk of cardiovascular disease, and when these girls then become women and become pregnant themselves, they are already more likely to have more severe hypertension and diabetes during pregnancy. to get. ,” said Dr. Kartik K. Venkatesh, the paper's first author, an obstetrician and perinatal epidemiologist at The 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 on children will be decades away, so the question becomes: What can we do here and now to maintain their cardiovascular health throughout their lives?” said dr. Venkatesh.

“Can we spot abnormalities in cardiovascular health early so we can treat them and implement interventions that can change long-term outcomes?”

Women planning a pregnancy can also benefit from seeking care even before they become pregnant, he added. More and more women are entering pregnancy with conditions – such as obesity, high blood pressure and diabetes – that increase their risk of heart disease. Part of the reason: Women postpone motherhood until later in life.

Of the 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 the time they were 12 years old, those whose mothers had high blood pressure during pregnancy had a 16 percent higher risk of heart problems, such as high cholesterol or being overweight, compared with those whose mothers had no complications.

The children of mothers with gestational diabetes were 11 percent more likely to have such an indicator, the researchers found. And children born to mothers with both conditions were almost 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, Arizona, said the findings were significant and could lead to earlier screening for and treatment of heart disease in children.

“I think this will actually change the guidelines for children and change the way we care for patients,” said Dr. Bond. “If your mother had an adverse outcome during pregnancy, we may need to screen you earlier. We should encourage people to learn about their family's medical history, including the complications their mothers had during pregnancy.”

While such guidelines do not yet exist, she added, “we have started the conversation.”

Dr. Annette Ansong, associate chief of outpatient cardiology at Children's National Hospital in Washington, D.C., said she began including questions about maternal health during pregnancy when taking medical histories of her young patients.

'I started asking the patient's parents: 'Did you have preeclampsia, hypertension or diabetes during your pregnancy?' I haven't done that before, and I suspect the majority of doctors don't,” said Dr. Ansong.

“With a family history, you're kind of focused on parents, aunts and uncles, grandparents, and what we don't normally ask is, 'What happened in the womb, in my mother's belly?'” she added .