Risk of high blood pressure starts before birth

2 March 2022: A ground-breaking new study by researchers at the University of Western Australia using data from the Raine Study has revealed that the risk of high blood pressure in adults can have its origin before birth. The study also found that lifestyle and environmental factors during pregnancy can increase an unborn child’s risk of heart disease and stroke later in life.

Published in the Journal of Hypertension, the study is the first to investigate the relationship between fetal growth patterns and blood pressure in adulthood using novel modelling techniques based on ultrasounds during pregnancy.

Lead author of the study, public health physician and PhD candidate Dr Ashish Yadav, said previous studies had used birth weight as a proxy for growth in the womb and reported an association between low birthweight and elevated blood pressure in adulthood.

“However, we used ultrasound measurements at different stages of pregnancy from the Raine Study, one of the largest prospective cohorts of pregnancy, childhood, adolescence and adulthood carried out in the world, which provide a better reflection of fetal growth,” Dr Yadav said.

“We found that babies whose head and abdominal growth during pregnancy is below average are at greater risk of hypertension during adulthood with their systolic blood pressure 3.5 mmHg higher.”

Dr Yadav said population studies had shown that a 3.5 mmHg higher blood pressure in adults corresponded to a 6-10 per cent higher risk of death due to heart disease and a 10 per cent higher risk of stroke.

“Our study provides new evidence that there are different patterns of fetal growth and that they play a critical role in predisposing the offspring to risk of future heart disease and stroke,” he said.

“We also identified several maternal factors that are important such as mothers’ weight, smoking and hypertension in pregnancy and pregnancy-related diabetes, which all influence growth of the unborn child.”

Dr Yadav said health interventions targeting risk factors could potentially reduce the possibility of future cardiovascular disease.

“Early identification of at-risk babies could encourage a more cautious approach towards lifestyle and health-risk management in later life,” he said.

The team plan to continue using data from the Raine Study to investigate the relationship between fetal growth and other cardiometabolic risk factors in adulthood including obesity, diabetes and cholesterol as they work towards further interventions to mitigate risks for future populations.

Dr Yadav was a 2020 recipient of the Raine Study PhD Top-up Scholarship. The award is made to students of outstanding research promise in the area of human health and life-course epidemiology who can demonstrate that their research using Raine Study data will benefit the broader community.

Publication details:
Ashish YadavLawrence J BeilinRae-Chi HuangPhil VlaskovskyJohn P NewnhamScott W WhiteTrevor A Mori
The relationship between intrauterine foetal growth trajectories and blood pressure in young adults
J Hypertens., 2022 Mar 1;40(3):478-489

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