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Abstract: PO2236

Maternal Hypertension and Hypertensive Disorders of Pregnancy Are Associated with Increased Risk of Hypertension in Offspring

Session Information

Category: Women’s Health and Kidney Diseases

  • 2000 Women’s Health and Kidney Diseases

Authors

  • Dines, Virginia, Mayo Clinic Minnesota, Rochester, Minnesota, United States
  • Kattah, Andrea G., Mayo Clinic Minnesota, Rochester, Minnesota, United States
  • Weaver, Amy L., Mayo Clinic Minnesota, Rochester, Minnesota, United States
  • Chamberlain, Alanna, Mayo Clinic Minnesota, Rochester, Minnesota, United States
  • Bielinski, Suzette J., Mayo Clinic Minnesota, Rochester, Minnesota, United States
  • Mielke, Michelle M., Mayo Clinic Minnesota, Rochester, Minnesota, United States
  • Garovic, Vesna D., Mayo Clinic Minnesota, Rochester, Minnesota, United States
Background

Hypertensive disorders of pregnancy (HDP) have significant effects on perinatal outcomes for offspring. Although there is increasing evidence of adverse effects of HDP exposure on long-term health outcomes in offspring, the impact of maternal hypertension beyond HDP is limited.

Methods

We performed a population-based cohort study of 7544 women with 8755 pregnancies from 1976 to 1982. HDP during each offspring’s birth was identified using a previously validated algorithm. Diagnosis of hypertension in mothers (before or after the pregnancy) and in offspring was determined using diagnostic codes through 2019. Associations were evaluated using Cox proportional hazards models adjusted for maternal age at delivery, child’s sex, fetal weight percentile and gestational age.

Results

Among offspring, the cumulative incidence of hypertension was 5.7% (95%CI 5.1-6.4%) by the offspring’s age of 30, 9.5% (95% CI 8.7-10.3%) by age 35, and 16.2% (95% CI 15.0-17.5%) by age 40. HDP exposure at birth (HR 1.49, 95%CI 1.19-1.87) and maternal hypertension as a time-dependent covariate (HR 1.73, 95%CI 1.48-2.02) were associated with an increased risk of hypertension in offspring. Maternal hypertension was associated with a 1.6-fold (95%CI 1.37-1.92) increased risk of hypertension among offspring without HDP exposure compared to a 2.3-fold (95%CI 1.40-3.78) increased risk among offspring with HDP exposure; however this difference was not significant (p-interaction=0.18). We also performed a landmark analysis to evaluate maternal hypertension prior to age 55 as a static covariate. Compared to offspring without HDP exposure and without maternal hypertension prior to age 55, HDP exposure was not associated with risk of hypertension in offspring (HR 0.58, 95%CI 0.27-1.22) whereas maternal hypertension (HR 1.65, 95%CI 1.34-2.03) or the presence of both (HR 2.44, 95%CI 1.59-3.15) conferred an increased risk.

Conclusion

HDP exposure at birth and maternal hypertension are independently associated with an increased risk of hypertension in offspring. Our results suggest the possibility of an interaction effect for offspring exposed to HDP at birth and maternal hypertension, however this requires further research.

Funding

  • Other NIH Support