Associations of Maternal Cardiovascular Health in Pregnancy With Offspring Cardiovascular Health in Early Adolescence

The gestational period during pregnancy may be an opportune time to influence not only the health of the mother but also the long-term health of the offspring. Risk factors, such as obesity and diabetes, during pregnancy have been independently associated with higher risks of poor cardiovascular health (CVH). The association of the combination of these risk factors may further increase this risk. The aim of this study was to examine the long-term risks of maternal CVH on their offspring. This was an ancillary, cohort study using data from the Hyperglycemia and Adverse Pregnancy Outcomes Follow-Up Study (2013-2016). Included in the cohort for this analysis were mother-offspring dyads who had been followed 10 to 14 years after delivery. Maternal CVH was evaluated during a study examination at a target of 28 weeks of gestation based on 5 metrics: body mass index (BMI), blood pressure (BP), total cholesterol level, glucose level, and smoking. Offspring CVH was evaluated during a study examination at 10 to 14 years of age based on 4 metrics: BMI, BP, total cholesterol level, and glucose level. Each of the maternal and offspring metrics was categorized as ideal, intermediate, or poor. Total CVH was then categorized and scored separately for mother and offspring as follows: all-ideal metrics, >= 1 intermediate and 0 poor metrics, 1 poor metric, and >= 2 poor metrics. The maximum CVH score was 10 points for mothers and 8 points for offspring. There were 2302 mother-offspring dyads included in the analysis. The mean (SD) CVH score was 8.6 (1.4) of 10 for the mothers and 6.8 (1.3) of 8 for the offspring. Among the mothers, 32.8% had all-ideal metrics and 6.0% had >= 2 poor metrics (95% confidence interval [CI], 30.6-35.1 and 95% CI, 3.8-8.3, respectively). Among the offspring, 37.3% had all-ideal metrics and 4.5% had >= 2 poor metrics (95% CI, 35.0-39.6 and 95% CI, 2.3-6.8, respectively). The prevalence rate of offspring with all-ideal CVH was 42.2% (95% CI, 38.4-46.2) among those who also had mothers with all-ideal CVH metrics and 30.7% (95% CI, 22.0%-40.4%) among those who had mothers with >= 2 poor CVH metrics. For every 1-point improvement in maternal CVH score, significant improvements were also observed in CVH scores for offspring, including a 0.19-point higher CVH score (95% CI, 0.15-0.23) and relative risk of 1.15 (95% CI, 1.10-1.21) for all-ideal metrics. In conclusion, the better a pregnant person's CVH is during pregnancy, the better the CVH outcomes are among offspring up to 14 years of age, and vice versa.