Weight gain in pregnancy, triceps skinfold thickness, and blood pressure in offspring

Objective: To determine whether women who are poorly nourished in early pregnancy, as determined by triceps skinfold thickness, or who have poor pregnancy weight gain have offspring with higher blood pressure (BP). Methods: We evaluated 296 11-year-old children born to women who had taken part in a study of nutrition in pregnancy. Women had been weighed at 18 and 28 weeks' gestation and had had their triceps skinfold thickness measured at 18 weeks. In our follow-up study, their children were weighed and had their BP recorded. Blood pressure was adjusted for weight, gender, ethnic group, cuff size, and time of measurement. Results: The children's mean (standard deviation [SD]) systolic BP was 106 (12) mmHg and their mean (SD) diastolic BP was 62 (7) mmHg. Maternal triceps skinfold thickness at 18 weeks' gestation and maternal pregnancy weight gain between 18 and 28 weeks' gestation were weakly inversely related to the children's BF. However, among women with triceps skinfold thickness at 18 weeks below the group median (15 mm), reduced pregnancy weight gain was associated with significantly higher BP in the offspring; systolic pressure increased by 11.3 mmHg (95% confidence interval [CI] 2.2, 20.4) and diastolic pressure by 10.1 mmHg (95% CI 3.2, 17.1) for each kilogram-per-week decrease in pregnancy weight gain. Conclusion: In women who were poorly nourished in early pregnancy, reduced pregnancy weight gain was associated with higher BP in the 11-year-old offspring. We suggest that fetal adaptations to poor maternal nutrition lead to elevated BP in childhood but adequate maternal weight gain during pregnancy may protect against this.