Higher in utero vitamin D levels may prevent high BP in children: JAMA
USA: Higher cord vitamin D blood levels in pregnant women with preeclampsia may lower the risk of high blood pressure (BP) in their children during childhood and adolescence, finds a recent study. Results of the study, published in the journal JAMA Network Open suggests that optimizing the maternal prenatal vitamin D levels may prevent high BP and future cardiovascular disease (CVD) in children born to women with preeclampsia.
Maternal preeclampsia could be a risk factor for high BP in children. However, there is no information on whether the intergenerational association between maternal preeclampsia and BP in their children differs by cord blood vitamin D levels. Mingyu Zhang, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, and colleagues, therefore, assessed the associations between maternal preeclampsia and offspring systolic BP across childhood and adolescence. They also tested whether these associations vary by cord blood 25-hydroxyvitamin D [25(OH)D] concentrations -- a biomarker of in utero vitamin D status.
The researchers analyzed 6669 SBP observations from 754 mother-child pairs from the Boston Birth Cohort. They were enrolled in the Boston Birth Cohort from 1998 to June 2009. Data were analyzed from October 2019 to March 2020.
The primary outcome was repeated SBP measures between 3 and 18 years of age.
Key findings of the study include:
- There were 6669 SBP observations from the 754 children; 50.0% were female and 18.6% were born preterm.
- Of the 754 mothers, 62.2% were Black and 10.5% had preeclampsia.
- Median cord blood 25(OH)D was 12.2.
- Maternal preeclampsia was associated with 5.34 percentile higher SBP after adjusting for confounders.
- This association varied by quartiles of cord blood 25(OH)D concentrations: the differences in SBP percentile comparing children born to mothers with vs without preeclampsia were 10.56 for quartile 1 (lowest), 7.36 for quartile 2, 4.94 for quartile 3, and –1.87 for quartile 4 (highest).
- When cord blood 25(OH)D was analyzed continuously, children born to mothers with preeclampsia had 3.47 percentile lower SBP per 5 ng/mL 25(OH)D increment.
- These associations did not differ by child sex or developmental stages.
According to the authors, maternal preeclampsia is associated with higher child BP from early childhood to adolescence but adequate cord blood 25(OH)D levels may modify this association.
"Future prospective birth cohorts and clinical trials are needed to confirm this benefit," they concluded.
The study, "Associations of Cord Blood Vitamin D and Preeclampsia With Offspring Blood Pressure in Childhood and Adolescence," is published in the journal JAMA Network Open.