Hypertension in Pregnancy Tied to Increased Risk of Stroke Years Later in Offspring

By Megan Brooks

June 04, 2021

NEW YORK (Reuters Health) - Exposure in the womb to maternal hypertensive disorders of pregnancy (HDP) is a risk factor for stroke four decades later, according to a large population-based study.

"Our findings indicate that hypertensive disorders during pregnancy are associated with increased risks of stroke and potentially heart disease in offspring up to the age of 41 years," Dr. Fen Yang of Karolinska Institutet, in Stockholm, said in a news release.

Dr. Yang presented the study at ESC Heart and Stroke 2021, an online scientific conference of the European Society of Cardiology.

Individuals born to mothers with HDP may benefit from early screening and preventive efforts to reduce the risk of heart disease and stroke later in life, Dr. Yang and colleagues write in their conference abstract.

It's known that children exposed to HDP have increased risks of preterm birth, fetal growth restriction and cardiovascular risk factors including high blood pressure, obesity and diabetes later in life. But less is known about whether there is a direct link between HDP and ischemic heart disease and stroke, the study team explains.

To investigate, they analyzed data on more than 5.8 million babies born in Sweden (from 1973 to 2014) and Finland (from 1987 to 2014) and followed for ischemic heart disease and stroke until 2014. A total of 218,322 (3.8%) babies were born to mothers with HDP.

During up to 41 years of follow-up, 2,340 (0.04%) offspring were diagnosed with ischemic heart disease and 5,360 (0.09%) suffered a stroke.

Offspring exposed to maternal HDP had 29% and 33% increased risks of ischemic heart disease and stroke, respectively, both statistically significant findings. The associations were independent of preterm birth and fetal growth restriction.

Maternal HDP remained significantly associated with stroke but not ischemic heart disease in sibling analyses.

"The sibling analyses suggest that shared genetic or environmental factors were the main contributors to the association between hypertensive pregnancy disorders and the risk of ischemic heart disease. However, the increased risk of stroke persisted, indicating the possibility of direct intrauterine effects," Dr. Yang said in the news release.

"It is important to note that our study is an observational study, and further studies with longer follow-up and that may contribute to a better understanding of the possible underlying mechanisms are warranted," Dr. Yang cautioned in email to Reuters Health.

"If our findings are supported by future studies, screening for risk factors like obesity, high blood pressure, and diabetes in children born to mothers with hypertensive disorders during pregnancy and preventive measures focusing on maternal health may be implemented very early in life to reduce the risk of cardiovascular diseases in later life. Knowledge about and action to influence maternal health may thus benefit two generations," Dr. Yang added.

The study had no commercial funding.

SOURCE: https://bit.ly/3pbJ5Ma ESC Heart and Stroke 2021, online June 2-4, 2021.