Background and Aims A variety of maternal heart conditions are associated with abnormal placentation and reduced foetal growth. However, their impact on offspring’s long-term cardiovascular health is poorly studied. This study aims to investigate the association between intrauterine exposure to pre-existing maternal cardiovascular disease (CVD) and offspring CVD occurring from infancy to early adulthood, using paternal CVD as a negative control. Methods This nationwide cohort study used register data of live singletons without major malformations or congenital heart disease born between 1992 and 2019 in Sweden. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox proportional hazards models, adjusted for essential maternal characteristics. Paternal CVD served as a negative control for assessment of unmeasured genetic and environmental confounding. Results Of the 2 597 786 offspring analysed (49.1% female), 26 471 (1.0%) were born to mothers with pre-existing CVD. During a median follow-up of 14 years (range 1–29 years), 17 382 offspring were diagnosed with CVD. Offspring of mothers with CVD had 2.09 times higher adjusted HR of CVD (95% CI 1.83, 2.39) compared with offspring of mothers without CVD. Compared with maternal CVD, paternal CVD showed an association of smaller magnitude (HR 1.49, 95% CI 1.32, 1.68). Increased hazards of offspring CVD were also found when stratifying maternal CVD into maternal arrhythmia (HR 2.94, 95% CI 2.41, 3.58), vascular (HR 1.59, 95% CI 1.21, 2.10), and structural heart diseases (HR 1.48, 95% CI 1.08, 2.02). Conclusions Maternal CVD was associated with an increased risk of CVD in offspring during childhood and young adulthood. Paternal comparison suggests that genetic or shared familial factors may not fully explain this association.

中文翻译：

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孕产妇既往心血管疾病和从婴儿期到成年早期后代心血管疾病的风险


背景和目的 多种孕产妇心脏病与胎盘异常和胎儿生长缓慢有关。然而，它们对后代长期心血管健康的影响研究很少。本研究旨在使用父亲 CVD 作为阴性对照，探讨宫内暴露于预先存在的母体心血管疾病 （CVD） 与从婴儿期到成年早期发生的后代 CVD 之间的关联。方法 这项全国性队列研究使用了 1992 年至 2019 年在瑞典出生的无严重畸形或先天性心脏病的活单胎的登记数据。使用 Cox 比例风险模型估计风险比 （HRs） 和 95% 置信区间 （CIs），并根据孕产妇的基本特征进行调整。父系 CVD 作为评估未测量的遗传和环境混杂的阴性对照。结果 在分析的 2 597 786 个后代 （49.1% 为女性） 中，26 471 个（1.0%） 是由患有 CVD 的母亲所生。在中位随访 14 年 （范围 1-29 年） 期间，17 382 名后代被诊断患有 CVD。与无 CVD 母亲的后代相比，患有 CVD 的母亲的后代的 CVD 校正 HR 高 2.09 倍 （95% CI 1.83， 2.39）。与母体 CVD 相比，父系 CVD 显示出较小幅度的相关性 （HR 1.49,95% CI 1.32,1.68）。将母体 CVD 分为母体心律失常 （HR 2.94， 95% CI 2.41， 3.58）、血管性 （HR 1.59， 95% CI 1.21， 2.10） 和结构性心脏病 （HR 1.48， 95% CI 1.08， 2.02） 时，也发现后代 CVD 的风险增加。结论 母体 CVD 与儿童期和青年期后代 CVD 风险增加相关。 父系比较表明，遗传或共同的家族因素可能无法完全解释这种关联。