Generation R Study Group and Departments of Epidemiology and Pediatrics, Erasmus Medical Center, Rotterdam, the Netherlands.
Circulation. 2010 Sep 21;122(12):1192-9. doi: 10.1161/CIRCULATIONAHA.110.936674. Epub 2010 Sep 7.
Offspring of women with hypertensive disorders of pregnancy are at increased risk of cardiovascular complications later in life, but the mechanisms underlying these associations are unclear. Our aim was to examine whether adjusting for birth weight and familial adiposity changed the association of hypertensive disorders of pregnancy with offspring blood pressure.
Using data from 6343 nine-year-old participants in the Avon Longitudinal Study of Parents and Children, we examined the association between hypertensive disorders of pregnancy (preeclampsia and gestational hypertension) and offspring blood pressure. Both preeclampsia and gestational hypertension were associated with systolic and diastolic blood pressures in the 9-year-old offspring; after adjustment for parental and own adiposity and for other potential confounders, the mean difference in systolic blood pressure was 2.05 mm Hg (95 confidence interval, 0.72 to 3.38) and 2.04 mm Hg (95 confidence interval, 1.42 to 2.67) for preeclampsia and gestational hypertension, respectively, compared with those with no hypertensive disorders of pregnancy. Equivalent results for diastolic blood pressure were 1.00 mm Hg (95 confidence interval, -0.01 to 2.10) and 1.07 mm Hg (95 confidence interval, 0.60 to 1.54). The association of preeclampsia with offspring systolic and diastolic blood pressures attenuated toward the null with further adjustment for birth weight and gestational age, whereas these adjustments did not attenuate the association of gestational hypertension with offspring blood pressure.
The associations of hypertensive disorders of pregnancy with higher offspring blood pressure are not explained by familial adiposity. The mechanisms linking preeclampsia and gestational hypertension with offspring blood pressure may differ, with the former mediated at least in part by the effect of preeclampsia on intrauterine growth restriction.
患有妊娠高血压疾病的女性的后代在以后的生活中发生心血管并发症的风险增加，但这些关联的机制尚不清楚。我们的目的是研究调整出生体重和家族肥胖后，妊娠高血压疾病与后代血压之间的关联是否发生变化。
我们利用 6343 名 9 岁儿童参与的阿冯纵向父母与子女研究的数据，研究了妊娠高血压疾病（子痫前期和妊娠期高血压）与后代血压之间的关系。子痫前期和妊娠期高血压均与 9 岁儿童的收缩压和舒张压有关；在校正父母和自身肥胖以及其他潜在混杂因素后，与无妊娠高血压疾病的儿童相比，收缩压的平均差异分别为 2.05mmHg（95%置信区间，0.72 至 3.38）和 2.04mmHg（95%置信区间，1.42 至 2.67）；舒张压的等效结果分别为 1.00mmHg（95%置信区间，-0.01 至 2.10）和 1.07mmHg（95%置信区间，0.60 至 1.54）。子痫前期与后代收缩压和舒张压的关联在进一步调整出生体重和胎龄后趋于零，而这些调整并没有减弱妊娠期高血压与后代血压之间的关联。
妊娠高血压疾病与后代较高血压之间的关联不能用家族肥胖来解释。子痫前期和妊娠期高血压与后代血压之间的联系机制可能不同，前者至少部分是由子痫前期对宫内生长受限的影响介导的。
