Association of maternal cardiovascular health in early-to-mid pregnancy with offspring cardiovascular phenotypes in early childhood: a prospective birth cohort study

To examine the association of maternal cardiovascular health (CVH) in early-to-mid pregnancy with offspring cardiovascular phenotypes in early childhood. A total of 980 mother-offspring pairs were included. Maternal CVH was composed of body mass index (BMI), blood pressure (BP), total cholesterol level, glucose level, and smoking status. Each metric was categorized into ideal, intermediate, or poor according to corresponding guidelines. Childhood BP measurement and transthoracic echocardiography were performed at age of 4. Compared to offspring from mothers with all ideal metrics, those from mothers with ≥2 poor metrics had higher BP (systolic: p = 0.01; diastolic: p < 0.01). Higher maternal CVH score was negatively associated with offspring mean BP (systolic: β: −0.38; 95% CI: −0.70, −0.06; diastolic: β: −0.36; 95% CI: −0.64, −0.08), while positively associated with offspring ventricular chamber diameter (LVEDD: β: 0.58; 95% CI: 0.03, 1.14; LVESD: β: 0.40; 95% CI: 0.04, 0.76), ventricular chamber volume (LVEDV: β: 1.06; 95% CI: 0.16, 1.97; LVESV: β: 0.41; 95% CI: 0.08, 0.74) and stroke volume (β: 0.58; 95% CI: 0.04, 1.11). There is a potential link between multifactorial maternal CVH during early-to-mid pregnancy and offspring early cardiovascular phenotypes, including differences in offspring BP, cardiac structure and function. Maternal cardiovascular health (CVH) is increasingly recognized as a key indicator of long-term cardiometabolic outcomes in offspring. This study indicates maternal CVH during early-to-mid pregnancy is associated with offspring blood pressure, cardiac structure and function at age 4. Findings suggest the potential value of multifactorial prenatal health assessment for identifying early-life cardiovascular risk, extending existing DOHaD and CVH literature.