145 Evidence of Hypertension but not Metabolic Disorders in Young Adults Born to Hypertensive Pregnancies

Abstract

Objective Children born to hypertensive pregnancies are known to have higher levels of cardiovascular risk factors. We studied whether by age 20 years they have developed hypertension or metabolic disorders that may warrant intervention. Methods We quantified cardiovascular risk in young adults born to hypertensive pregnancies using data fromthe 2868 offspring of women enrolled during pregnancy into Western Australia Pregnancy Cohort (Raine) Study, taking into account whether risk varies with severity of the hypertensive pregnancy syndrome and degree of prematurity. Results Young adults born to hypertensive pregnancies accounted for 30% of those with hypertensive blood pressures at age 20 years. Detailed pregnancy medical records demonstrated that a more complicated history, characterised as preeclampsia or preterm birth due to maternal hypertension, associated with a 3-fold (95% CI 1.3 to 7.0, p = 0×01) greater risk of hypertension, whereas, pregnancy-induced hypertension at term associated with a smaller blood pressure rise. Although incidence of overweight and obesity was 2-fold (95% CI 1.5 to 2.8, p = 0×001) higher in the pregnancy-induced hypertension group, body size did not account for blood pressure variation in either group and metabolic risk markers did not vary. Associations were consistent throughout life and independent of other birth-related factors. Conclusions Adults born following a complicated hypertensive pregnancy are significantly more likely to be hypertensive by age 20 years and exhibit a specific hypertensive phenotype without metabolic changes. Consideration of maternal pregnancy history may be of value to provide insight into why some young adults present with hypertension.