The role of maternal pre-existing cardiovascular disease for long-term health in offspring

Research problem and specific questionsThe population of pregnant women with a history of cardiovascular disease (CVD) is reportedly expanding globally, with wide-reaching implications for maternal and offspring health.

Although previous studies suggest that pre-existing heart diseases in pregnancy negatively affect normal placentation and neonatal outcomes, there is a scarcity of evidence regarding their impact on the longer-term health of offspring.

This project will generate new knowledge on the role of pre-existing maternal CVD for offspring´s health in the early decades of their life.

The targeted research questions are:A) Is pre-existing maternal CVD associated with offspring’s developmental and cardiovascular health outcomes? B) Is the association primarily driven by the intrauterine or the genetic pathway?

C) To what extent is the association mediated by maternal and fetal health complications?Data and methodWe will conduct population-based cohort studies using advanced methods of causal inference and paternal CVD as negative-control exposure.

The project will utilize rich data on about 4 million children born in Sweden and British Columbia (BC), Canada between 1992 and 2021, with up to 30-years of follow-up.

Information on maternal and paternal CVD, pregnancy and neonatal complications, and long-term cardiovascular and neuro-developmental outcomes in offspring will be derived from register databases.

In BC, we will also have access to unique survey data on child developmental vulnerability.Societal relevance and utilisationThe project will be the largest epidemiological study ever conducted on the impact of maternal CVD on offspring health.

It will contribute to our understanding of the mechanisms through which pre-existent maternal CVD may influence offspring health as they grow up.

In the context of rising prevalence of maternal CVD worldwide, such knowledge is expected to be of substantial societal and clinical relevance for designing prevention strategies.

The new knowledge will help promote clinical guidelines for improved health management of the women at risk and their children, and inform policies targeted at reducing inter-generational transmission of disease risks.Plan for project realisationThe project is part of an ongoing collaboration between Karolinska Institute and University of British Columbia.

The ethical permits for conducting the research are already in place. The data will be accessible for analysis immediately.