Blood Pressure Is Related to Placental Volume and Birth Weight

Abstract

Abstract-The objective of this study was to determine whether maternal nutrition and fetal and placental size program blood pressure. A longitudinal study linking the maternal anthropometric measurements of the first antenatal visit, ultrasound data of placental and fetal size, anthropometry at birth, and childhood growth and blood pressure was performed. The subjects were 428 women who attended the antenatal clinic at the University Hospital of the West Indies, Kingston, Jamaica, and their children, who were subsequently followed up. Systolic blood pressure at ages 1, 2, 2.5, 3, and 3.5 years was the main outcome measure. Pooling the data across ages, systolic blood pressure fell by 1.4 mm Hg for every 1-kg increase in birth weight (95% CI 0.2 to 2.7, Pϭ0.02) and by 1.2 mm Hg for every 100-mL increase in placental volume at 20 weeks of gestation (95% CI 0.4 to 2.0, Pϭ0.004). Blood pressure was also negatively associated with placental volume at 17 weeks and fetal abdominal circumference at 20 weeks. Measures of maternal nutritional status were strongly related to birth weight and placental volume but not directly to childhood blood pressure at these young ages. In conclusion, blood pressure is associated with fetal size in this population, as previously described among Europeans. We found associations between placental volume and abdominal circumference in the second trimester and childhood blood pressure, suggesting that the initiating events of blood pressure programming occur early in pregnancy. Measures of maternal nutritional status were not directly related to childhood blood pressure at these young ages but were strong predictors of both birth weight and placental volume, suggesting an indirect relation.

Developmental origins of cardiovascular risk in Jamaican children: The Vulnerable Windows Cohort Study

“…Height was measured to the nearest 0·1 cm with a stadiometer (CMS Weighing Equipment Ltd) (11) . Abdominal ultrasound was performed at 14, 17, 20, 25, 30 and 35 weeks of gestation using a linear probe (ATL Ultramark IV; Philips Medical Systems North America, Bothell, WA, USA).…”

“…Very little information on markers and mechanisms of underlying susceptibility is available for African-origin populations. The 'Vulnerable Windows Cohort Study' was established in the Tropical Metabolism Research Unit, University of the West Indies in 1993 as an observational study to describe such susceptibility to cardiovascular risk in black Jamaicans (11) . We hypothesised that small maternal size, small birth size and increased growth rates during early childhood are associated with increased cardiovascular risk in later childhood.…”

The effect of feto-maternal size and childhood growth on left ventricular mass and arterial stiffness in Afro-Caribbean children

“…Subjects and study design As previously described, 16 712 women attending the antenatal clinic at the University Hospital of the West Indies, Kingston, Jamaica, were invited to participate in a prospective study of intrauterine growth, and risk factors for chronic cardiovascular disease in later life. Inclusion criteria were the following: women who were aged between 15 and 40 years, were 7-10 weeks pregnant (which was confirmed by a 14-week ultrasound) and without systemic illnesses (for example, pre-eclampsia and diabetes) or genetic abnormality (for example, sickle cell disease).…”

“…Using a standardized protocol, 16 maternal weight was measured to the nearest 0.01 kg and height was measured to the nearest 0.1 cm. Abdominal ultrasound was performed using a linear probe (ATL Ultramark IV, Advanced Technology Labs, Bothell, WA, USA) at 14, 17, 20, 25, 30 and 35 weeks of gestation.…”

“…Placental volume was measured sonographically at 14, 17 and 20 weeks. 16 The long axis of the placenta was identified and a continuous recording of the image of the placenta orthogonal to the axis was carried out. This axis was divided into six sections of equal length; the five interior cross-sectional areas were measured and integrated to estimate placental volume.…”