Childhood risk factors and pregnancy-induced hypertension: The bogalusa heart study

BACKGROUND Pregnancy-induced hypertension (PIH) causes increased risk of maternal, fetal, and neonatal morbidity and mortality. Identification of risk factors for PIH in early life is central to the development of prevention strategies. METHODS A cohort of 703 women aged 25.5-51.3 years from the Bogalusa Heart Study were included. PIH were defined as self-reported hypertension during pregnancy and a blood pressure level <140/90mm Hg without antihypertensive medication (n = 131) at the subsequent examinations. Body mass index (BMI), systolic and diastolic blood pressure, high- and low-density lipoprotein cholesterol, and triglycerides measured during childhood (4-17 years) were considered. General linear models were used to examine differences in childhood between those who did and those who did not develop PIH. Logistic regression models were used to estimate odds ratios for PIH associated with childhood risk factors. RESULTS Compared to women who did not develop PIH, those who developed PIH had higher BMI (20.2 vs. 19.2kg/m², P = 0.0002) and systolic blood pressure (104.1 vs. 103.3mm Hg, P = 0.008) in childhood. After adjustment for other variables, childhood BMI was the only risk factor associated with PIH, with each standard deviation increase in childhood BMI being associated with an odds ratio of 1.35 (95% confidence interval: 1.08-1.68) for PIH. The odds of PIH increased significantly as childhood BMI increased from the bottom quartile to the top quartile (P for trend = 0.006). CONCLUSIONS Elevated childhood BMI is a significant risk factor for PIH in adulthood, which underscores the importance of body weight control in childhood for prevention of PIH.