Women who develop high blood pressure or diabetes during pregnancy are more likely to give birth to children who develop diseases at a younger age that can compromise their own heart health, scientists reported Monday.
These children are more likely to be overweight and diagnosed with high blood pressure, high cholesterol, and high blood sugar by age 12 compared to children whose mothers had uncomplicated pregnancies. .
Although this study falls short of proving causation, it does highlight the strong link between a healthy pregnancy and a healthy child. This conclusion also supports the “fetal origin of adult diseases'' hypothesis, which suggests that the cause of many chronic diseases may be the adaptation of the fetus to the uterine environment.
The findings come from a government-sponsored study that followed an international cohort of 3,300 mother-infant pairs for more than 10 years. The study was presented at the Society of Maternal-Fetal Medicine's annual pregnancy conference in National Harbor, Maryland. Abstract has been published In the January supplement of the Journal of the American College of Obstetricians and Gynecologists.
“This creates a potentially vicious cycle for children, who are at increased risk of cardiovascular disease and then, when they become women and become pregnant, they are already at risk of developing more severe hypertension and diabetes during pregnancy. '', said study lead author Dr. Kartik K. Venkatesh, an obstetrician and perinatal epidemiologist at The Ohio State University Wexner Medical Center in Columbus.
The findings demonstrate the urgency for preventive care and early intervention to stop this cycle, both during pregnancy and in early childhood, he added.
“The impact on children will be decades from now, so the question is what can we do here and now to maintain lifelong cardiovascular health,” said Dr. Venkatesh. .
“Can we detect abnormalities in cardiovascular health early, treat them, and implement interventions that may change long-term outcomes?”
She added that women planning a pregnancy could also benefit from receiving care before they become pregnant. More and more women are starting their pregnancies with conditions that increase their chances of heart disease, such as obesity, high blood pressure and diabetes. Part of the reason is that women are putting off motherhood until later in their lives.
Of the 3,317 pregnant women who participated in the study, 263 (8 percent) developed pregnancy-related hypertension, 402 (12 percent) had gestational diabetes, and 82 (2.5 percent) had both conditions during pregnancy. Diagnosed.
By the age of 12, those whose mothers had high blood pressure during pregnancy had a 16% higher risk of developing heart disease indicators such as high cholesterol and being overweight than those born to mothers without complications. .
Researchers found that children born to mothers with gestational diabetes were 11 percent more likely to exhibit such signs. Children of mothers with both conditions were also nearly 20% more likely to show early signs of cardiovascular disease.
Dr. Rachel M. Bond, a cardiologist and system director for Women's Heart Health at Dignity Health in Chandler, Arizona, said the discovery is important and could lead to earlier screening and treatment of heart disease in children. He said there is.
“I think this will really change pediatric guidelines and change the way patients are cared for,” Dr. Bond said. “If your mother had an adverse outcome during pregnancy, maybe we should test you sooner. should be encouraged to know about their medical history.”
She added that there are no such guidelines yet, but “we are starting the conversation.”
Dr. Annette Anson, vice chief of ambulatory cardiology at Children's National Hospital in Washington, D.C., said she has begun to include questions about the mother's health during pregnancy when taking medical histories with young patients.
“I started asking my patients' parents, 'Did you have pre-eclampsia, high blood pressure, or diabetes during your pregnancy?' I never did that before, and my guess is… So I think the majority of doctors don't do that,” Dr. Anson said.
“When we talk about family history, we focus more or less on our parents, aunts and uncles, and grandparents, but what we don't usually ask is, 'What was going on in your womb, in your mother's womb?' I mean,” she added.