Sanderson Keia, Oran Ali, Singh Rachana, Gogcu Semsa, Perrin Eliana M, Washburn Lisa, Zhabotynsky Vasyl, South Andrew M, Jensen Elizabeth T, Fry Rebecca C, O'Shea T Michael
Department of Medicine-Nephrology, University of North Carolina, Chapel Hill, NC, USA.
Institute for Environmental Health Solutions, University of North Carolina, Chapel Hill, NC, USA.
Pediatr Nephrol. 2025 Feb;40(2):463-472. doi: 10.1007/s00467-024-06523-1. Epub 2024 Sep 24.
The aim of this study was to evaluate associations between pre-pregnancy maternal obesity and adolescent blood pressures (BPs) among children born extremely preterm.
This longitudinal observational cohort study included participants in the multicenter Extremely Low Gestational Age Newborn (ELGAN) study, born before 28 weeks of gestation, recruited at birth between 2002 and 2004, and followed prospectively through late adolescence. Between 2015 and 2022, three oscillometric BPs were obtained from participants (mean age 17.8 years). We used linear regression modeling to evaluate the association between maternal self-reported pre-pregnancy body mass index (BMI) and offspring adolescent systolic BP (SBP). In secondary analyses, we evaluated the association between maternal pre-pregnancy and offspring preadolescent (10-year-old) BMI and between offspring preadolescent BMI and adolescent SBP.
The 100 (24%) participants born to a mother with a history of pre-pregnancy obesity (BMI ≥ 30) had a greater mean SBP of 120.5 (± 14.3) mmHg compared to the 324 (76%) of adolescents born to mothers without pre-pregnancy obesity (SBP 115.6 (± 12.0) mmHg). Pre-pregnancy obesity was associated with higher offspring BMI (aβ 10.8, 95% CI 2.3, 19.2), and higher offspring BMI was associated with higher adolescent SBP (aβ 0.12, 95% CI 0.09,0.16).
For ELGANs, higher maternal pre-pregnancy BMI was associated with higher adolescent SBP. Findings from secondary analyses suggest potential mediation through preadolescent BMI. Future research directions include multi-level interventions to reduce maternal pre-pregnancy obesity, followed by offspring obesity prevention interventions as a way of reducing intergenerational cardiovascular disease in high-risk infants born extremely preterm.
本研究旨在评估极早产儿出生后，孕前母亲肥胖与青少年血压（BP）之间的关联。
这项纵向观察性队列研究纳入了多中心极低孕周新生儿（ELGAN）研究的参与者，这些婴儿在2002年至2004年期间出生，孕周小于28周，并在出生后进行前瞻性随访直至青春期后期。2015年至2022年期间，对参与者（平均年龄17.8岁）进行了三次示波血压测量。我们使用线性回归模型来评估母亲自我报告的孕前体重指数（BMI）与后代青少年收缩压（SBP）之间的关联。在二次分析中，我们评估了母亲孕前BMI与后代青春期前（10岁）BMI之间的关联，以及后代青春期前BMI与青少年SBP之间的关联。
100名（24%）母亲有孕前肥胖史（BMI≥30）的参与者，其平均收缩压为120.5（±14.3）mmHg，高于324名（76%）母亲无孕前肥胖史的青少年（收缩压115.6（±12.0）mmHg）。孕前肥胖与后代较高的BMI相关（调整β值为10.8，95%置信区间为2.3，19.2），而后代较高的BMI与青少年较高的收缩压相关（调整β值为0.12，95%置信区间为0.09，0.16）。
对于ELGAN研究对象，母亲孕前BMI较高与青少年较高的收缩压相关。二次分析结果表明，可能通过青春期前BMI产生中介作用。未来的研究方向包括多层次干预措施，以减少母亲孕前肥胖，随后进行后代肥胖预防干预，作为降低极早产高危婴儿代际心血管疾病的一种方式。
