History of maternal pregnancy characteristics, birth weight, and subclinical arterial disease in young adults in the Jerusalem Perinatal Study

Abstract

<bold>Introduction:</bold> There is mounting evidence that the intrauterine environment affects the risk of clinical cardiovascular health in the adult offspring. We studied subclinical disease mechanisms that may account, at least in part, for this association by examining the associations of birth weight (BW), pre-pregnancy BMI (ppBMI), and smoking during pregnancy with offspring measurements of subclinical arterial disease. <bold>Methods:</bold> Using the EndoPAT2000 device we measured the Augmentation Index (AI), a measurement of arterial stiffness, and the Reactive Hyperemia Index (RHI), a measurement of endothelial function, in 400 subjects from the Jerusalem Perinatal Family Follow-up Study (JPS-1). The JPS-1 includes data on maternal and pregnancy characteristics collected from an interview taken shortly after birth; weight, height, and BP measurements collected at age 17; and a detailed interview, and physical exam conducted at age 32. We repeated the models adjusting for offspring BMI at age 17 and age 32 and for other maternal and offspring lifestyle, socioeconomic, and demographic characteristics. <bold>Results:</bold> We found an inverse linear association between BW and AI (β=-0.439, 95% CI (-0.830,-0.048) for a 100g increase in BW) limited to females, that remained after adjustment for offspring obesity but was attenuated after adjustment for other maternal and offspring characteristics. We did not find an association between BW and RHI. We found an inverse ‘U’ shape association between ppBMI and RHI that remained after adjustment for maternal and offspring characteristics, including offspring obesity. For example, compared to a ppBMI of 19 kg/m<super>2</super>, a ppBMI of 24 kg/m<super>2</super> was associated with a 0.14 higher mean offspring RHI (95% CI 0.004, 0.28), while compared to a ppBMI of 29 kg/m<super>2</super>, a ppBMI of 34 kg/m<super>2</super> was associated with a 0.18 lower mean offspring RHI (95% CI -0.40, -0.002). We did not find an association between ppBMI and offspring AI. There was no evidence of an association between smoking during pregnancy and offspring arterial characteristics. <bold>Conclusion:</bold> Our findings contribute to the evidence that maternal ppBMI and offspring BW may affect offspring clinical cardiovascular health later in life, and suggest that the effect may be partly due to changes in offspring subclinical arterial characteristics.