pregnancy-related blood pressure disorders

Disorders that can cause abnormally high blood pressure during pregnancy are associated with increased risk of death in offspring from birth through adolescence, finds study published by BMJMore today.

Findings based on data from over 2 million Danish individuals show that offspring born to mothers with hypertensive pregnancy disorder (HDP) are at increased risk of death. Abnormal high blood pressure and other complications during pregnancy.

HDP affects up to 10% of pregnancies worldwide and is one of the leading causes of illness and death in mothers and their infants.

HDP is also associated with several conditions in later offspring, including metabolic syndrome (a combination of diabetes, hypertension, and obesity), immune disorders, neurodevelopmental disorders, and psychiatric disorders. However, evidence for HDP on long-term offspring mortality from birth through puberty and beyond is lacking.

To address this knowledge gap, researchers set out to examine associations between maternal HDP and offspring overall and specific mortality from birth to young adulthood.

Using data from the Danish National Health Register, we analyzed 2.4 million individuals born in Denmark between 1978 and 2018 by date of birth, date of death, date of migration, or date of 31 December 2018. I tracked down whichever came first.

The main outcome they are concerned with is death from any cause (“all-cause mortality”), followed by 13 specific causes of death in offspring from birth through young adulthood to age 41. continued.

These included death from cardiovascular disease, cancer, psychiatric and behavioral disorders, neurological and musculoskeletal disease, and birth defects.

Potential influencing factors such as offspring sex, maternal age at birth, maternal education level, income, living environment, smoking during pregnancy and medical history were considered.

Of the 2,437,718 offspring included in the analysis, 102,095 (4.2%) were prenatally exposed to HDP, 68,362 (2.8%) were exposed to preeclampsia or eclampsia, and 33,733 (1.4%) were exposed to high blood pressure;

781 born to preeclamptic mothers (59 per 100,000 person-years), 17 born to eclamptic mothers (134 per 100,000 person-years), 223 during a mean follow-up of 19 years (44 deaths per 100,000 person-years). person-years) were born to a hypertensive mother, and 19,119 (42 of her per 100,000 person-years) were born to her non-HDP mother.

The results show that all-cause mortality was higher in maternally exposed offspring to HDP compared to the unexposed group.

HDP-exposed offspring had a 26% (55 per 100,000 person-years) higher risk of all-cause mortality than unexposed offspring. The associated increased risks of pre-eclampsia, eclampsia, and hypertension were 29% (59 per 100,000 person-years), 188% (134 per 100,000 person-years), and 12% (44 per 100,000 person-years), respectively.

Offspring whose mothers had early onset of severe pre-eclampsia had a >6-fold higher risk of death than those whose mothers did not have HDP. Strong associations were also found between offspring of mothers with HDP and a history of diabetes or low levels of education.

There was also an increased risk of death by some causes. For example, deaths from conditions attributable to gastrointestinal disease and perinatal (pregnancy or first year of life) more than doubled among offspring exposed to her HDP in the mother, endocrine, nutritional and metabolic , deaths from cardiovascular disease further increased. over 50.

However, the researchers found no significant association between maternal HDP and offspring cancer deaths.

As this was an observational study, we were unable to determine causation and the researchers were able to identify factors that were not measured, such as smoking, alcohol use, poor diet, obesity, and the sedentary lifestyle of the offspring. I admit that I could not eliminate the influence.

They also point out that Denmark has universal health insurance with high-quality medical services, which may limit the generalizability of the findings.

Nevertheless, this was a large, long-term study based on high-quality public health data. The results are consistent after additional sibling analyzes that consider the influence of genetic factors and some unmeasured familial factors, suggesting they are robust.

As such, the researchers conclude that this study suggests that maternal HDP, particularly eclampsia and severe pre-eclampsia, is a risk factor for overall mortality and specific mortality from a variety of causes in offspring from birth to young adulthood. provide strong evidence that it is associated with an increase in

Further studies are needed to examine the underlying physiological mechanisms between maternal HDP and offspring mortality, they add.