The association between maternal blood pressures and offspring size at birth in Southeast Asian women

Abstract

BackgroundMaternal blood pressures in pregnancy is an important determinant of offspring size at birth. However, the relationship between maternal blood pressures and offspring’s size at birth is not consistent and may vary between ethnic groups. We examined the relationship between maternal peripheral and central blood pressures and offspring size at birth in an Asian multi-ethnic cohort, and effect modifications by maternal ethnicity and obesity.MethodsWe used data from 713 participants in the Growing Up in Singapore Towards Healthy Outcomes study consisting of pregnant Chinese, Malay and Indian women recruited from two tertiary hospitals between 2009 to 2010. Peripheral systolic and diastolic blood pressures (SBP and DBP), and central SBP and pulse pressure (PP) were measured around 27 weeks of gestation. Biometric parameters at birth were collected from medical records.ResultsAfter adjusting for maternal and fetal covariates, each 1-SD increase (10.0 mmHg) in central SBP was inversely associated with birth weight (−40.52 g; 95% confidence interval (CI) -70.66 to −10.37), birth length (−0.19 cm; −0.36 to −0.03), head circumference (−0.12 cm; −0.23 to −0.02) and placental weight (−11.16 g; −20.85 to −1.47). A one-SD (11.1 mmHg) increase in peripheral SBP was also associated with lower birth weight (−35.56 g; −66.57 to −4.54). The inverse relations between other blood pressure measures and offspring size at birth were observed but not statistically significant. Higher peripheral SBP and DBP and central SBP were associated with increased odds of low birth weight (defined as weight <2500 g) and small for gestational age (defined as <10th percentile for gestational age adjusted birth weight). Maternal adiposity modified these associations, with stronger inverse associations in normal weight women. No significant interactions were found with ethnicity.ConclusionsHigher second-trimester peripheral and central systolic pressures were associated with smaller offspring size at birth, particularly in normal weight women. Findings from this study reinforces the clinical relevance of antenatal blood pressure monitoring.Electronic supplementary materialThe online version of this article (doi:10.1186/s12884-014-0403-1) contains supplementary material, which is available to authorized users.

Impact of pregnancy-induced hypertension on fetal growth

“…Apart from that, both the mean of birth length and also head circumference were the lowest in severe preeclampsia (47.62±4.16 cm and 31.62±2.34 cm respectively). The result was similar to the study by Lim et al 23 which declared that peripheral systolic blood pressure would decrease birth weight, birth length, head circumference, and placental weight (all p<0.05). Each 1 SD (11.1 mmHg) increase of peripheral systolic blood was inversely associated with birth weight (-35.56 g; 95% CI=-66.57 to -4.54), birth length (-0.16 cm; 95% CI=-0.32-0.01), head circumference (-0.09 cm; 95% CI=-0.19-0.02), and placental weight (-8.78 g; 95% CI=-18.74-1.19).…”

Metabolomic Profiling of Pregnancies With Polycystic Ovary Syndrome Identifies a Unique Metabolic Signature and Potential Predictive Biomarkers of Low Birth Weight

“…Our data is in accord with previous studies that have reported an increased prevalence of small-for-gestational-age offspring in women with PCOS ( 5 , 29 ) with no difference in gestational age at delivery. It is recognized that mothers with higher blood pressure had offspring with lower birth weight ( 30 , 31 ) that we also showed here; however, in addition we report the novel finding of a negative correlation between maternal blood pressure in the second trimester and baby birth weight at delivery that may suggest a functional relationship between baby birth weight and maternal blood pressure as early as the second trimester. When considering potential indicative metabolic biomarkers of birth weight, our data revealed that SBP at delivery was the strongest predictor of low birth weight.…”

Identification of High-Risk Pregnancies in a Remote Setting Using Ambulatory Blood Pressure: The MINDI Cohort

“…Higher PP was associated with lower birthweight in a cohort of 50 normotensive women from the Netherlands (99). Also, European (100) and Asian studies (101) have shown that elevated SBP and DBP were associated with impaired fetal growth. Although few studies have addressed hypotension as a potential risk factor for SGA, we found that low PP (but not low SBP, DBP, or MAP) was associated with SGA fetuses in our cohort of women participating in normal pregnancy follow up.…”