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Pediatrics

Joint effect of maternal plasma homocysteine and prepregnancy obesity on child blood pressure: a prospective birth cohort study

International Journal of Obesity volume 41, pages 1447–1453 (2017)Cite this article

Subjects

Abstract

Background/Objectives:

Elevated homocysteine (Hcy) is a known cardiovascular risk factor. However, its role in intergenerational cardiometabolic risk is unknown. We hypothesized that maternal elevated Hcy can act alone or in combination with maternal prepregnancy obesity to increase child systolic blood pressure (SBP).

Methods:

This study included 1279 mother-child pairs who were enrolled at birth and followed prospectively up to age 9 years from 2003 to 2014 at the Boston Medical Center. Child SBP percentile was calculated according to US reference data and elevated SBP was defined as SBP⩾75th percentile.

Results:

A U-shaped relationship between maternal Hcy and her child SBP was observed. The risk for child elevated SBP was higher among those in the lowest quartile (Q1, odds ratio (OR): 1.27; 95% confidence interval (CI): 0.94–1.72), and highest quartile (Q4, OR: 1.34; 95% CI: 1.00–1.81) as compared with those in quartiles 2 and 3. The highest risk of child elevated SBP was found among children born to obese mothers with Hcy in Q4 (OR: 2.22; 95%CI: 1.35–3.64), compared with children of non-obese mothers with Hcy in Q2–Q3. This association was independent from maternal folate and vitamin B12 status, and was not mediated by gestational age or size at birth.

Conclusions:

In this prospective birth cohort, we observed a U-shaped association between maternal Hcy levels and child elevated SBP. Maternal high Hcy (Q4) and prepregnancy obesity jointly increased the risk of child elevated SBP by more than two-fold.

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Acknowledgements

We wish to thank all of the study participants and the Boston Medical Center Labor and Delivery Nursing Staff for their support and help with the study. We thank TR Bartell (Ann & Robert H Lurie Children’s Hospital of Chicago, Stanley Manne Children’s Research Institute, Chicago, USA) for English editing. The Boston Birth Cohort (the parent study) was supported in part by the March of Dimes PERI grants (20-FY02-56, #21-FY07-605), and the National Institutes of Health (NIH) grants (R21ES011666, 2R01HD041702, R21HD066471). The follow-up study is supported in part by the NIH grants (U01AI090727, R21AI079872, R01HD086013); and the Maternal and Child Health Bureau (R40MC27443). Dr. Hongjian Wang is supported by a Chinese Scholarships Council scholarship, grants from the National Natural Science Foundation of China (81300156) and PUMC Youth Fund/the Fundamental Research Funds for the Central Universities (3332015103).

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Authors and Affiliations

  1. Department of Cardiovascular Internal Medicine, State Key Laboratory of Cardiovascular Disease, National Clinical Research Center of Cardiovascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China

    H Wang

  2. Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA

    H Wang, B P Xu, R B Xu, S O Walker & G Wang

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Correspondence to G Wang.

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Wang, H., Xu, B., Xu, R. et al. Joint effect of maternal plasma homocysteine and prepregnancy obesity on child blood pressure: a prospective birth cohort study. Int J Obes 41, 1447–1453 (2017). https://doi.org/10.1038/ijo.2017.109

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