Children born to mothers with cardiometabolic health issues before or during pregnancy may face a higher risk of elevated blood pressure in childhood and adolescence, according to a new study funded by the Environmental influences on Child Health Outcomes (ECHO) Program at the National Institutes of Health (NIH).
High blood pressure in childhood often continues into adulthood and is linked to a greater risk of heart problems later in life. This ECHO research offers insights into how a mother's heart and metabolic health before and during pregnancy may contribute to her child's long-term cardiovascular well-being.
The study analyzed data from 12,480 mother-child pairs in the ECHO Program. Researchers looked at how three maternal cardiometabolic risk factors—pre-pregnancy obesity, gestational diabetes, and high blood pressure during pregnancy—were related to children's blood pressure from ages 2 to 18.
Key Findings:
- 44% of mothers in the study had at least one cardiometabolic risk factor during pregnancy.
- Children whose mothers had more than one condition, such as gestational diabetes combined with high blood pressure or pre-pregnancy obesity, had higher blood pressure than those whose mothers had only one condition.
- Children born to these mothers had higher average blood pressure readings, even after accounting for age, sex, and height of the child.
- These children also experienced an increased rate of change in blood pressure over time, suggesting a long-term impact.
- The effect was especially strong for diastolic blood pressure in girls and systolic blood pressure in non-Hispanic Black children whose mothers had gestational diabetes or high blood pressure.
"With declines in cardiometabolic health, it's important to focus on prevention starting as early as possible," said ECHO researcher Zhongzheng Niu, PhD, of the Keck School of Medicine at the University of Southern California. "Our study suggests that helping people improve their health before and during pregnancy could benefit both mothers and future generations."
The researchers in this study call for further studies to understand how combinations of maternal health issues and broader social and structural factors contribute to these long-term risks.
This collaborative research is published in JAMA Network Open .
Niu, Z. Maternal Cardiometabolic Risk Factors in Pregnancy and Offspring Blood Pressure at Age 2-18 Years. JAMA Network Open, DOI: 10.1001/jamanetworkopen.2025.9205.
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