Oral Plenary Session I and Late-Breaking
Oral Plenary Sessions
Kartik Kailas Venkatesh, MD, PhD (he/him/his)
Assistant Professor
The Ohio State University
Columbus, Ohio, United States
Sadiya S. Khan, MD, MSc
Assistant Professor of Medicine
Northwestern University Feinberg School of Medicine
Oak Park, IL, United States
.jpg "Mark B. Landon, MD photo")
Mark B. Landon, MD
Richard L. Meiling Professor and Chair, Obstetrics and Gynecology
The Ohio State University Wexner Medical Center
Columbus, OH, United States
To examine the association of hypertensive disorders of pregnancy (HDP) and gestational diabetes (GDM) with child cardiovascular health (CVH) in early adolescence.
Study Design:
A secondary analysis from the prospective Hyperglycemia and Adverse Pregnancy Outcome (HAPO) Follow-up Study. The exposure (expressed as a multiple dichotomous variable) was HDP alone, GDM alone, or both HDP and GDM, compared with none of these (reference). The primary outcome was child CVH at ages 10 to 14 years, based on four metrics: body mass index, blood pressure, total cholesterol level, and glucose level. Each metric was categorized as ideal, intermediate, or poor using pediatric guidelines. The primary outcome was having at least one metric that was non-ideal versus all ideal (reference). We also secondarily examined to what extent the exposures were associated with progressive decrements in CVH by categorizing CVH according to the number of non-ideal metrics: at least one intermediate metric, one poor metric, or at least two poor metrics versus all ideal. Modified Poisson models adjusted for field center, parity, maternal age at enrollment, gestational age at enrollment, pregnancy alcohol or tobacco use, child’s sex, and child’s age at CVH assessment.
Results: Among 3,317 assessed maternal-child dyads, 7.9% (n=263) pregnant individuals developed HDP alone, 12.1% (n=402) GDM alone, and 2.5% (n=82) both HDP and GDM. When the children were at a median age of 11.6 years, 55.5% (n=1808) had at least one metric that indicated less-than-ideal CVH. In adjusted models, individuals with HDP alone (aRR 1.16; 95% CI 1.04, 1.28), GDM alone (aRR 1.11; 95% CI 1.02, 1.21), and both HDP and GDM (aRR 1.17; 95% CI 1.00, 1.38) were more likely to have children with less-than-ideal CVH 10-14 years after delivery. Secondary analyses revealed that the associations strengthened in magnitude as the adverse CVH metrics increased in number and severity (TABLE).
Conclusion: Pregnant individuals in the HAPO FUS cohort with HDP, GDM, or both were more likely to have children with worse CVH 10 to 14 years after their delivery.