Hypertensive Disorders of Pregnany and Offspring Cardiac Structure and Function in Adolescence

Background Fetal exposure to preeclampsia is associated with higher blood pressure (BP) and later risk of stroke. We aimed to investigate the associations of maternal preeclampsia, gestational hypertension, and maternal BP change in pregnancy with offspring cardiac structure and function in adolescence.

Methods and Results Using data from a prospective birth cohort study, we included offspring who underwent echocardiography (mean age 17.7 years, SD 0.3, N=1,592). We examined whether hypertensive disorders of pregnancy (HDP) were associated with offspring cardiac structure and systolic/diastolic function using linear regression. Using multilevel linear spline models (measurement occasions within women), we also investigated whether rate of maternal systolic/diastolic BP change during pregnancy (weeks 8-18, 18-30, 30-36, and 36 or more) were associated with offspring outcomes. Main models were typically adjusted for maternal age, pre-pregnancy BMI, parity, glycosuria/diabetes, education, and smoking. Exposure to maternal preeclampsia (0.025; 95% confidence interval 0.008 to 0.043) and gestational hypertension (0.010; 0.002 to 0.017) were associated with greater relative wall thickness (RWT). Furthermore, preeclampsia was also associated with a smaller left ventricular end diastolic (LVED) volume (-9.0 ml; -15 to -3.1). No associations were found between HDP and offspring cardiac function. Positive rate of maternal systolic BP change during weeks 8-18 was associated with greater offspring LVED volume, left ventricular mass indexed to height (LVMI), and E/A.

Conclusions Adolescent offspring exposed to maternal preeclampsia had greater RWT and reduced LVED volume, which could be early signs of concentric remodeling and affect future cardiac function as well as risk of CVD.