Obstetrician-assessed maternal health at pregnancy predicts offspring future health

Cerebrovascular disease at young age is related to mother's health during the pregnancy-The Northern Finland Birth Cohort 1966 study

BACKGROUND AND PURPOSE

For prevention of cerebrovascular diseases at younger age, it is important to understand the risk factors occurring early in life. We investigated the relationship between mothers' general health during pregnancy and the offspring's risk of cerebrovascular disease in age of 15 to 52 years.

METHODS

Within the population-based prospective Northern Finland Birth Cohort 1966, 11,926 persons were followed from antenatal period to 52 years of age. Information on their mother's ill health conditions, i.e., hospitalizations, chronic diseases, medications, vitamin or iron supplement, fever, anemia, mood, and smoking was collected from 24th gestational week onwards. Ischemic and hemorrhagic cerebrovascular diseases of the offspring were identified from national registers in Finland. Cox proportional hazard models were used to estimate the association of mother's health conditions with incidence of cerebrovascular disease in the offspring, with adjustments for potential confounders.

RESULTS

During 565,585 person-years of follow-up, 449 (2.8%) of the offspring had a cerebrovascular disease. Hospitalization during pregnancy was associated with an increased risk of cerebrovascular disease in the offspring (hazard ratio (HR) = 1.49; 95% confidence interval (CI) 1.06-2.08) after adjustment for confounders, as was having more than three ill health conditions (HR = 1.89; CI 1.14-3.11). Not using vitamin or iron supplement was associated with increased risk for cerebrovascular disease in the offspring (HR = 1.39; CI 1.01-1.89).

CONCLUSIONS

The results suggest that the risk of cerebrovascular disease may start as early as during the antenatal period, and the health characteristics of mothers during pregnancy may play a role in cerebrovascular disease risk of the offspring.

Pregnancy complications and calculated cardiovascular risk in urban women: do we envisage an association?

Most researches related to pregnancy complications and future cardiovascular disease, and their risk factors have been equivocal. Existence and extent of these complications, as a contributing factor to CVD risks, with underlying mechanisms of these associations, still remain uncertain. Hence, the current study tends to examine associations between "complicated pregnancies" with obesity markers known to be coherent reflections of cardiovascular health in urban women. A cross-sectional sample of 631 Punjabi Khatri (mean age: 33 ± 5.58 years) urban women was studied for associations of pregnancy diabetes mellitus, hypertensive disorders, preterm delivery, and size for GA with calculated 10-year CVD risk (based on the Framingham score). A wide range of obesity markers (BMI, waist circumference (WC), WHR, and WHtR) were measured 3-8 years postpregnancy to determine its association with complications during pregnancy. The association with the calculated 10-year CVD risk (≥10 %) based on the Framingham prediction score was 3.01 OR (2.11-3.72 CI) for pregnancy DM, 4.52 (3.68-4.93 CI) for preeclampsia/gestational hypertension, 2.16 (2.01-2.79 CI) for size at GA (SGA and LGA), 2.25 (1.91-2.85 CI) for preterm births, and 2.48 (2.08-3.98 CI) for abnormal birth weight when compared with women without pregnancy diabetes mellitus, preeclampsia/gestational hypertension, appropriate gestational age, full-term babies, and normal birth weight, respectively, in completely adjusted models. Therefore, HDP, pregnancy diabetes mellitus, and pregnancy outcomes are all associated with an increased risk of CVD 10 years later. Pregnancy may provide an opportunity to identify women at increased risk of CVD relatively early in life.