Blood pressure during pregnancy, neonatal size and altered body composition: the Healthy Start study

• Published in: Journal of perinatology 2017-05, Vol.37 (5), p.502-506
• Main Authors: Starling, A P, Shapiro, A L B, Sauder, K A, Kaar, J L, Ringham, B M, Glueck, D H, Galan, H L, Dabelea, D
• Format: Article
• Language: English
• Subjects: 692/308/174; 692/499; 692/699/75/243/793; Adolescent; Birth Weight; Birth weight, Low; Blood Pressure; Blood Pressure Determination; Body Composition; Body fat; Body Mass Index; Body size; Childbirth & labor; Colorado; Confidence intervals; Epidemiology; Fat-free body mass; Female; Gestational age; Health aspects; Health care; Hospitals; Humans; Hypertension; Infant, Newborn; Infant, Small for Gestational Age; Linear Models; Logistic Models; Medical records; Medicine; Medicine & Public Health; Missing data; Multivariate Analysis; Neonates; Newborn babies; Obstetrics; Offspring; original-article; Pediatric Surgery; Pediatrics; Physiological aspects; Pregnancy; Pregnancy Trimester, Second; Pregnancy Trimester, Third; Pregnant women; Premature birth; Prospective Studies; Public health; Regression analysis; Regression models; Risk factors; Statistical analysis; Weight; Young Adult
• ISSN: 0743-8346; 1476-5543
• DOI: 10.1038/jp.2016.261

Objective: The objective of this study is to estimate associations between changes in maternal arterial pressure during normotensive pregnancies and offspring birth weight and body composition at birth. Study Design: Prospective study of 762 pregnant normotensive Colorado women, recruited from outpatient obstetrics clinics. Repeated arterial pressure measurements during pregnancy were averaged within the second and third trimesters, respectively. Multivariable regression models estimated associations between second to third trimester changes in arterial pressure and small-for-gestational-age birth weight, fat mass, fat-free mass and percent body fat. Results: A greater second to third trimester increase in maternal arterial pressure was associated with greater odds of small-for-gestational-age birth weight. Greater increases in maternal diastolic blood pressure were associated with reductions in offspring percent body fat (−1.1% in highest vs lowest quartile of increase, 95% confidence interval: −1.9%, −0.3%). Conclusion: Mid-to-late pregnancy increases in maternal arterial pressure, which do not meet clinical thresholds for hypertension are associated with neonatal body size and composition.