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Background  Hypertensive disorders of pregnancy are related to higher offspring blood pressure ( BP ), but it is not known whether this association strengthens or weakens as  BP  changes across childhood. Our aim was to assess the associations of hypertensive disorders of pregnancy and maternal  BP  changes during pregnancy with trajectories of offspring  BP  from age 7 to 18 years.    Methods and Results  In a large  UK  cohort of maternal–offspring pairs (N=6619), we used routine antenatal  BP  measurements to derive hypertensive disorders of pregnancy and maternal  BP  trajectories. These were related to offspring  BP  trajectories, obtained from research clinic assessments, using linear spline random‐effects models. After adjusting for maternal and offspring variables, including body mass index, offspring of women who had existing hypertension, gestational hypertension, or preeclampsia during pregnancy had on average higher  BP  at age 7 years compared to offspring of normotensive pregnancies (mean difference [95% CI ] in systolic  BP : 1.67 mm Hg [0.48, 2.86], 1.98 mm Hg [1.32, 2.65], and 1.22 mm Hg [−0.52, 2.97], respectively). These differences were consistent across childhood to age 18 years, as the patterns of  BP  change did not differ between offspring of hypertensive pregnancies and normotensive pregnancies. Maternal  BP  at 8 weeks’ gestation was also positively associated with offspring  BP  in childhood and adolescence, but changes in  BP  across pregnancy were not strongly associated.    Conclusions  The differences in  BP  between offspring of hypertensive pregnancies and offspring of normotensive pregnancies remain consistent across childhood and adolescence. These associations appear to be most contributed to by higher maternal  BP  in early pregnancy rather than by pregnancy‐related  BP  changes.

journal of the american heart association

Associations of Blood Pressure in Pregnancy With Offspring Blood Pressure Trajectories During Childhood and Adolescence: Findings From a Prospective Study