Heart disease may start in the womb, new study finds

CHICAGO - A new report reveals that a child’s future heart health could be partially shaped before they are born. 

More than 1,300 mother-child pairs studied

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Researchers at Northwestern Medicine evaluated nearly 1,350 mother-child pairs from the Future of Families and Child Well-Being Study, which enrolled mothers and children at birth between 1998 and 2000 across 20 U.S. cities. The children were then followed into adulthood.

Using delivery hospitalization records, the Northwestern scientists first identified whether mothers experienced pregnancy complications, including high blood pressure during pregnancy, gestational diabetes (high blood sugar during pregnancy) or preterm birth (before 37 weeks of pregnancy).

The research team then analyzed the cardiovascular health of the offspring at age 22, using blood pressure measurements, blood testing, body mass index assessments and carotid artery ultrasounds to look for signs of artery injury.

The scientists compared participants with and without exposure to each pregnancy complication and adjusted for factors like income, education, difference in birth weight and smoking during pregnancy.

Pregnancy complications linked to poor cardiovascular health in offspring

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The team found that pregnancy complications were linked to poorer cardiovascular health in offspring more than 20 years later.

Young adults whose mothers had high blood pressure during pregnancy – either pregnancy-associated hypertension, pre-eclampsia or eclampsia — had more signs of early arterial injury, higher blood pressure, higher body mass index and higher blood sugar than peers.

At around age 22, participants whose mothers had high blood pressure during pregnancy had a higher body mass index (+2.8 BMI points), higher diastolic blood pressure (+2.3 mm Hg), higher blood sugar levels (+0.2% HbA1c) and thicker artery walls (~0.02 mm).

While the difference in artery wall thickness may seem small, the study authors said it corresponded to roughly three to five years of additional vascular aging. That means arteries looked older and less healthy than expected, which raises the risk of future heart disease.

What they're saying:

"Before this study, we knew that mothers’ health during pregnancy influenced their children’s health," Dr. Nilay Shah, a lead researcher of the study told FOX Local. "What our study shows is that the child’s exposure to these cardiovascular and metabolic conditions while in utero may influence their heart health decades later when they are young adults. This was most surprising to me — that these very early life exposures while a child is still developing in utero may have long-reaching health effects more than two decades later."

Growing evidence of cardiovascular risk across generations

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The findings, which were published earlier this month in JAMA Network Open, add to growing evidence that cardiovascular risk may be transmitted across generations through a combination of biological, environmental and behavioral factors.

But Shah said the good news is that most heart disease is preventable. 

"If you experienced high blood pressure or high blood sugar during pregnancy, or your child was born early, it does not absolutely mean that your child will have worse health as adults," Shah continued. "But, I would encourage you to pay attention now to your child’s health behaviors. What children learn in childhood sets the stage for their health across their lives." 

He said heart-healthy behaviors, such as getting regular exercise and physical activity, eating a healthful diet, and never smoking, are habits that start in childhood. 

The link between heart disease and family health history

Why you should care:

High blood pressure, gestational diabetes and preterm birth affect almost one in four pregnancies in the U.S.

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According to the Centers for Disease Control and Prevention, having a family health history of heart disease makes a person more likely to develop heart disease themselves. 

In some cases, having family members with heart disease at a young age (age 50 or younger) can be a sign of familial hypercholesterolemia, a genetic disorder that causes high cholesterol.