Is infant arterial stiffness associated with maternal blood pressure in pregnancy? Findings from a UK birth cohort (Baby VIP study)

Ka Ying Bonnie Ng, Nigel A B Simpson, Janet E Cade, Darren C Greenwood, Harry J Mcardle, Etienne Ciantar, Nisreen A Alwan, Ka Ying Bonnie Ng, Nigel A B Simpson, Janet E Cade, Darren C Greenwood, Harry J Mcardle, Etienne Ciantar, Nisreen A Alwan

Abstract

Background: In adults, arterial stiffness measured by pulse wave velocity (PWV) is regarded as a predictor of cardiovascular disease. Infant vascular development depends on factors related to pregnancy, including maternal blood pressure (BP). This study assessed the association between maternal BP in pregnancy and infant brachio-femoral PWV at age 2-6 weeks.

Methods: The Baby Vascular health and Iron in Pregnancy (Baby VIP) study is a birth cohort which measured PWV and heart rate (HR) in 284 babies in Leeds, UK, at 2-6 weeks after birth. Maternal BP measurements at 12 and 36 weeks gestation was collected from antenatal clinical records. Multivariable linear regression models assessed associations between maternal systolic and diastolic BPs, and BP change from booking to 36 weeks, with infant PWV adjusting for covariables at both mother and baby level.

Results: There was no evidence of an association between infant PWV and maternal systolic BP at booking (adjusted regression coefficient -0.01 m/s per 10mmHg, 95% CI -0.11, 0.14, p = 0.84) or at 36 weeks (adjusted regression coefficient 0.00 m/s per 10mmHg, 95% CI -0.12, 0.11, p = 0.95). Change between 12 and 36 weeks gestation of more than 30 mmHg in systolic BP or 15 mmHg in diastolic BP was also not associated with infant PWV. There was an inverse relationship between infant HR and infant PWV (regression coefficient -0.14 m/s per 10 bpm, 95% CI -0.22, -0.05, p<0.01).

Conclusions: This study has shown no evidence of association between infant PWV at 2-6 weeks of age and maternal BP in early or late pregnancy. Infant HR was inversely associated with infant PWV. Further studies are required to determine the predictors of infant PWV as well as the importance and long term implications of PWV measurements in infants.

Conflict of interest statement

The authors have declared that no competing interests exist.

References

    1. Laurent S, Cockcroft J, Van Bortel L, Boutouyrie P, Giannattasio C, Hayoz D, et al. Expert consensus document on arterial stiffness: methodological issues and clinical applications. European heart journal. 2006;27(21):2588–605. 10.1093/eurheartj/ehl254 .
    1. Cruickshank K, Riste L, Anderson SG, Wright JS, Dunn G, Gosling RG. Aortic pulse-wave velocity and its relationship to mortality in diabetes and glucose intolerance: an integrated index of vascular function? Circulation. 2002;106(16):2085–90. .
    1. O'Rourke MF, Nichols WW, Safar ME. Pulse waveform analysis and arterial stiffness: realism can replace evangelism and scepticism. Journal of hypertension. 2004;22(8):1633–4; author reply 4. .
    1. Safar ME, Blacher J, Pannier B, Guerin AP, Marchais SJ, Guyonvarc'h PM, et al. Central pulse pressure and mortality in end-stage renal disease. Hypertension. 2002;39(3):735–8. .
    1. Boutouyrie P, Laurent S, Girerd X, Benetos A, Lacolley P, Abergel E, et al. Common carotid artery stiffness and patterns of left ventricular hypertrophy in hypertensive patients. Hypertension. 1995;25(4 Pt 1):651–9. .
    1. Verbeke F, Segers P, Heireman S, Vanholder R, Verdonck P, Van Bortel LM. Noninvasive assessment of local pulse pressure: importance of brachial-to-radial pressure amplification. Hypertension. 2005;46(1):244–8. 10.1161/01.HYP.0000166723.07809.7e .
    1. Barker DJ, Osmond C, Golding J, Kuh D, Wadsworth ME. Growth in utero, blood pressure in childhood and adult life, and mortality from cardiovascular disease. Bmj. 1989;298(6673):564–7. ; PubMed Central PMCID: PMC1835925.
    1. National High Blood Pressure Education Program Working Group on High Blood Pressure in C, Adolescents. The fourth report on the diagnosis, evaluation, and treatment of high blood pressure in children and adolescents. Pediatrics. 2004;114(2 Suppl 4th Report):555–76. .
    1. Law CM, Shiell AW. Is blood pressure inversely related to birth weight? The strength of evidence from a systematic review of the literature. Journal of hypertension. 1996;14(8):935–41. .
    1. Lurbe E, Redon J, Alvarez V, Durazo R, Gomez A, Tacons J, et al. Relationship between birth weight and awake blood pressure in children and adolescents in absence of intrauterine growth retardation. American journal of hypertension. 1996;9(8):787–94. .
    1. Huxley RR, Shiell AW, Law CM. The role of size at birth and postnatal catch-up growth in determining systolic blood pressure: a systematic review of the literature. Journal of hypertension. 2000;18(7):815–31. .
    1. Law CM, de Swiet M, Osmond C, Fayers PM, Barker DJ, Cruddas AM, et al. Initiation of hypertension in utero and its amplification throughout life. Bmj. 1993;306(6869):24–7. ; PubMed Central PMCID: PMC1676382.
    1. Lurbe E, Torro MI, Carvajal E, Alvarez V, Redon J. Birth weight impacts on wave reflections in children and adolescents. Hypertension. 2003;41(3 Pt 2):646–50. 10.1161/01.HYP.0000048341.52293.7C .
    1. Zinner SH, Lee YH, Rosner B, Oh W, Kass EH. Factors affecting blood pressures in newborn infants. Hypertension. 1980;2(4 Pt 2):99–101. .
    1. Seidman DS, Laor A, Gale R, Stevenson DK, Mashiach S, Danon YL. Pre-eclampsia and offspring's blood pressure, cognitive ability and physical development at 17-years-of-age. British journal of obstetrics and gynaecology. 1991;98(10):1009–14. .
    1. Himmelmann A, Svensson A, Hansson L. Relation of maternal blood pressure during pregnancy to birth weight and blood pressure in children. The Hypertension in Pregnancy Offspring Study. Journal of internal medicine. 1994;235(4):347–52. .
    1. Vatten LJ, Romundstad PR, Holmen TL, Hsieh CC, Trichopoulos D, Stuver SO. Intrauterine exposure to preeclampsia and adolescent blood pressure, body size, and age at menarche in female offspring. Obstet Gynecol. 2003;101(3):529–33. .
    1. Ibsen KK, Gronbaek M. Familial aggregation of blood-pressure in newly born infants and their mothers. Acta paediatrica Scandinavica. 1980;69(1):109–11. .
    1. Gillman MW, Rich-Edwards JW, Rifas-Shiman SL, Lieberman ES, Kleinman KP, Lipshultz SE. Maternal age and other predictors of newborn blood pressure. The Journal of pediatrics. 2004;144(2):240–5. 10.1016/j.jpeds.2003.10.064 .
    1. Bramham K, Parnell B, Nelson-Piercy C, Seed PT, Poston L, Chappell LC. Chronic hypertension and pregnancy outcomes: systematic review and meta-analysis. Bmj. 2014;348:g2301 10.1136/bmj.g2301 ; PubMed Central PMCID: PMC3988319.
    1. Alwan NA, Cade JE, Greenwood DC, McArdle HJ, Ciantar E, Simpson NA. PPO.09 The relationship between birthweight and brachio-femoral pulse wave velocity in early infancy: findings from a British birth cohort (Baby VIP study). Arch Dis Child Fetal Neonatal Ed. 2014;(99):A153.
    1. Koudsi A, Oldroyd J, McElduff P, Banerjee M, Vyas A, Cruickshank JK. Maternal and neonatal influences on, and reproducibility of, neonatal aortic pulse wave velocity. Hypertension. 2007;49(1):225–31. 10.1161/01.HYP.0000250434.73119.7a .
    1. Steer PJ, Little MP, Kold-Jensen T, Chapple J, Elliott P. Maternal blood pressure in pregnancy, birth weight, and perinatal mortality in first births: prospective study. Bmj. 2004;329(7478):1312 10.1136/bmj.38258.566262.7C ; PubMed Central PMCID: PMC534837.
    1. Friedman EA, Neff RK. Hypertension-hypotension in pregnancy. Correlation with fetal outcome. Jama. 1978;239(21):2249–51. .
    1. Alwan NA, Cade JE, McArdle HJ, Greenwood DC, Hayes HE, Ciantar E, et al. Infant Arterial Stiffness and Maternal Iron Status in Pregnancy: A UK Birth Cohort (Baby VIP Study). Neonatology. 2015;107(4):297–303. PubMed Central PMCID: PMCPMC4386106. 10.1159/000377618
    1. Alwan NA, Cade JE, McArdle HJ, Greenwood DC, Hayes HE, Simpson NA. Maternal iron status in early pregnancy and birth outcomes: insights from the Baby's Vascular health and Iron in Pregnancy study. The British journal of nutrition. 2015;113(12):1985–92. 10.1017/S0007114515001166 ; PubMed Central PMCID: PMC4498461.
    1. van Leeuwen-Segarceanu EM, Tromp WF, Bos WJ, Vogels OJ, Groothoff JW, van der Lee JH. Comparison of two instruments measuring carotid-femoral pulse wave velocity: Vicorder versus SphygmoCor. Journal of hypertension. 2010;28(8):1687–91. 10.1097/HJH.0b013e32833a8b83 .
    1. Shahin Y, Barakat H, Barnes R, Chetter I. The Vicorder device compared with SphygmoCor in the assessment of carotid-femoral pulse wave velocity in patients with peripheral arterial disease. Hypertens Res. 2013;36(3):208–12. Epub 2012/10/05. 10.1038/hr.2012.144 .
    1. Beevers G, Lip GY, O'Brien E. ABC of hypertension: The pathophysiology of hypertension. Bmj. 2001;322(7291):912–6. ; PubMed Central PMCID: PMC1120075.
    1. National Institute of Health and Care Excellence (NICE). Hypertension in pregnancy: diagnosis and management 2010 [7.4.16]. Available from: .
    1. James PR, Nelson-Piercy C. Management of hypertension before, during, and after pregnancy. Heart. 2004;90(12):1499–504. Epub 2004/11/18. doi: 90/12/1499 [pii] 10.1136/hrt.2004.035444 ; PubMed Central PMCID: PMC1768605.
    1. Laogun AA, Gosling RG. In vivo arterial compliance in man. Clinical physics and physiological measurement: an official journal of the Hospital Physicists' Association, Deutsche Gesellschaft fur Medizinische Physik and the European Federation of Organisations for Medical Physics. 1982;3(3):201–12. .
    1. Tanaka H, Munakata M, Kawano Y, Ohishi M, Shoji T, Sugawara J, et al. Comparison between carotid-femoral and brachial-ankle pulse wave velocity as measures of arterial stiffness. Journal of hypertension. 2009;27(10):2022–7. 10.1097/HJH.0b013e32832e94e7 .
    1. Barker DJ. The fetal and infant origins of adult disease. Bmj. 1990;301(6761):1111 ; PubMed Central PMCID: PMC1664286.
    1. Kelleher CM, McLean SE, Mecham RP. Vascular extracellular matrix and aortic development. Current topics in developmental biology. 2004;62:153–88. 10.1016/S0070-2153(04)62006-0 .
    1. Park BJ, Lee HR, Shim JY, Lee JH, Jung DH, Lee YJ. Association between resting heart rate and arterial stiffness in Korean adults. Archives of cardiovascular diseases. 2010;103(4):246–52. 10.1016/j.acvd.2010.03.004 .
    1. Cheung YF. Arterial stiffness in the young: assessment, determinants, and implications. Korean circulation journal. 2010;40(4):153–62. 10.4070/kcj.2010.40.4.153 ; PubMed Central PMCID: PMC2859331.
    1. Keehn L, Milne L, McNeill K, Chowienczyk P, Sinha MD. Measurement of pulse wave velocity in children: comparison of volumetric and tonometric sensors, brachial-femoral and carotid-femoral pathways. J Hypertens. 2014;32(7):1464–9; discussion 9. 10.1097/HJH.0000000000000203 ; PubMed Central PMCID: PMC4059550.
    1. van der Meer RW, Diamant M, Westenberg JJ, Doornbos J, Bax JJ, de Roos A, et al. Magnetic resonance assessment of aortic pulse wave velocity, aortic distensibility, and cardiac function in uncomplicated type 2 diabetes mellitus. Journal of cardiovascular magnetic resonance: official journal of the Society for Cardiovascular Magnetic Resonance. 2007;9(4):645–51. 10.1080/10976640601093703 .
    1. Chen S, Chetty S, Lowenthal A, Evans JM, Vu C, Stauffer KJ, et al. Feasibility of neonatal pulse wave velocity and association with maternal hemoglobin A1c. Neonatology. 2015;107(1):20–6. 10.1159/000366467 .

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