Abstract P149: Associations Between Perinatal Risk Factors and Childhood Cholesterol and Blood Pressure

Abstract

Introduction: There is growing evidence that early-life risk factors may influence the development of cardiovascular disease (CVD) in later life. The goal of this study was to examine the associations between numerous early life exposures and subsequent childhood hypertension and dyslipidemia at 11 years of age to identify the modifiable risk factors. Methods: The study used longitudinally linked data from three cross-sectional datasets in West Virginia (N= 22,136). The outcome variables included pre-hypertension/hypertension defined as ≥ 90th percentile for SBP (>124mmHg) or DBP (>80mmHg) and dyslipidemia defined as LDL ≥130mg/dl and HDL <40 mg/dl. Logistic regression was used to examine the association between the two outcomes and an extensive list of perinatal predictors, including sex, race, health insurance status, family history of cholesterol and cardiovascular disease, smoking during pregnancy, maternal age at birth, breastfeeding intention at birth, and birth weight of the infant. Results: The results showed that approximately 21% (4482 of 21817) of the children had hypertension and one fourth had dyslipidemia (24.6%, 4481 of 18184) in fifth grade. Increased odds for childhood hypertension was associated with age of the child in fifth grade, male gender, race (other compared to white), family history of cholesterol, and no maternal intention of exclusively breastfeeding their infant. Increased odds for childhood dyslipidemia was associated with family history of cholesterol, family history of cardiovascular disease, and maternal smoking during pregnancy. Notably, two modifiable perinatal risk factors stood out: mothers who did not intend to exclusively breastfeed had children who had significantly higher odds of having hypertension in fifth grade (OR: 1.2, 95%CI: 1.1, 1.3) compared to mothers who intended to exclusively breastfeed. Additionally, mothers who smoked during pregnancy had children who had significantly higher odds of having dyslipidemia in fifth grade compared to mothers who did not smoke (OR: 1.3, 95%CI: 1.2, 1.4). Conclusion: Surprisingly few perinatal factors were associated with childhood hypertension and dyslipidemia. The perinatal modifiable factors for hypertension and dyslipidemia included intent to breastfeed and maternal smoking during pregnancy; thus, smoking cessation and exclusive breastfeeding should be encouraged.