Document Detail

Prenatal factors for childhood blood pressure mediated by intrauterine and/or childhood growth?
MedLine Citation:
PMID:  21300676     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: Some prenatal factors may program an offspring's blood pressure, but existing evidence is inconclusive and mechanisms remain unclear. We examined the mediating roles of intrauterine and childhood growth in the associations between childhood systolic blood pressure (SBP) and 5 potentially modifiable prenatal factors: maternal smoking during pregnancy; prepregnancy BMI; pregnancy weight gain; chronic hypertension; and preeclampsia-eclampsia.
METHODS: The sample contained 30 461 mother-child pairs in the Collaborative Perinatal Project. Prenatal data were extracted from obstetric forms, and children's SBP was measured at 7 years of age. Potential mediation by intrauterine growth restriction (IUGR) and childhood growth was examined by the causal step method.
RESULTS: Heavy maternal smoking during pregnancy was significantly associated with higher offspring SBP (adjusted mean difference versus nonsmoking: 0.73 mm Hg [95% confidence interval (CI): 0.32-1.14]), which attenuated to null (0.13 [95% CI: -0.27-0.54]) after adjustment for changes in BMI from birth to 7 years of age. Prepregnancy overweight-obesity was significantly associated with higher offspring SBP (versus normal weight: 0.89 mm Hg [95% CI: 0.52-1.26]), which also attenuated to null (-0.04 mm Hg [95% CI: -0.40-0.31]) after adjustment for childhood BMI trajectory. Adjustment for BMI trajectory augmented the association between maternal pregnancy weight gain and offspring SBP. Adjustment for childhood weight trajectory similarly changed these associations. However, all these associations were independent of IUGR.
CONCLUSIONS: Childhood BMI and weight trajectory, but not IUGR, may largely mediate the associations of maternal smoking during pregnancy and prepregnancy BMI with an offspring's SBP.
Xiaozhong Wen; Elizabeth W Triche; Joseph W Hogan; Edmond D Shenassa; Stephen L Buka
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Publication Detail:
Type:  Comparative Study; Journal Article; Multicenter Study; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.     Date:  2011-02-07
Journal Detail:
Title:  Pediatrics     Volume:  127     ISSN:  1098-4275     ISO Abbreviation:  Pediatrics     Publication Date:  2011 Mar 
Date Detail:
Created Date:  2011-03-02     Completed Date:  2011-05-10     Revised Date:  2013-06-30    
Medline Journal Info:
Nlm Unique ID:  0376422     Medline TA:  Pediatrics     Country:  United States    
Other Details:
Languages:  eng     Pagination:  e713-21     Citation Subset:  AIM; IM    
Epidemiology Section, Department of Community Health, Brown University, 121 South Main St, Providence, RI 02912, USA.
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MeSH Terms
Blood Pressure / physiology
Body Mass Index
Child Development / physiology*
Child, Preschool
Fetal Development / physiology*
Follow-Up Studies
Hypertension / epidemiology,  etiology,  physiopathology*
Infant, Newborn
Maternal Exposure / adverse effects*
Pre-Eclampsia / epidemiology,  physiopathology*
Prenatal Exposure Delayed Effects / physiopathology*
Smoking / adverse effects*
United States / epidemiology
Young Adult
Grant Support
P50 CA084719/CA/NCI NIH HHS; R40MC03600-01-00//PHS HHS

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