Maternal nutritional status in pregnancy and blood pressure in childhood

Abstract

Objective To examine the relation between indices of maternal nutrition during pregnancy, including haemoglobin concentration, skinfold thickness and body weight, and the child's blood pressure at 10 to 12 years of age. Design Follow up study of children whose mothers had haemoglobin estimations, weights and skinfold thicknesses recorded during pregnancy. Setting Kingston, Jamaica. Subjects Seventy-seven children whose mothers took part in a prospective study of nutrition during pregnancy in relation to fetal growth. Main outcome measure Blood pressure at 10 to 12 years of age. Results The child's mean systolic pressure adjusted for current weight rose by 2.6 mmHg (95 % CI 0.5–4.6, P= 0.01) for each 1 g/dl fall in the mother's lowest haemoglobin during pregnancy. Mothers with a lower haemoglobin had thinner skinfold thicknesses, especially over the triceps (P= 0.005). In multiple regression analyses, taking account of the child's sex and current weight, there was a strong association between thin maternal triceps skinfold thickness at 15 weeks of gestation and raised blood pressure in the offspring. Taking account of the mother's triceps skinfold thickness abolished the relation between lower haemoglobin and raised blood pressure in the child. Lower weight gain between 15 and 35 weeks of gestation was independently associated with raised children's blood pressure. Systolic pressure rose by 10.7 mmHg (95 % CI 5.7 to 15.6, P= 0.0001) for each log mm decrease in the mother's triceps skinfold thickness, and by 0.6 mmHg (95% CI 0.1 to 1.0, P= 0.02) for each 1 kg decrease in the mother's weight gain during pregnancy. Conclusions These results parallel animal experiments suggesting that impaired maternal nutrition may underlie the programming of adult hypertension during fetal life.