Impact of maternal nutritional supplementation on offspring blood pressure
Hawkesworth, Sophie Ann;
(2010)
Impact of maternal nutritional supplementation on offspring blood pressure.
PhD thesis, London School of Hygiene & Tropical Medicine.
DOI: https://doi.org/10.17037/PUBS.00682418
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Observational studies on the association
between birth
weight and adult
blood
pressure provide suggestive evidence that
exposures
during fetal development
can
have lasting impacts on health. The effect of maternal
nutrition
during
pregnancy
on offspring blood pressure has been demonstrated in
animal models,
but
data
from cohort studies in humans have
proven
inconclusive. The follow-up
of
randomised controlled trials of nutritional supplementation
during
pregnancy can
add high quality data to this research
field; this thesis focuses
on the
effects
in
three separate trials.
Protein energy supplementation provided to
pregnant women
in
rural
Gambia
was
unrelated to offspring blood pressure
at
11-17
years
old
(n=1267).
Again in
The
Gambia, maternal calcium supplementation compared to
placebo
was also
unrelated to offspring blood pressure
at
5-10
years
old
(n=350).
In rural Bangladesh there was no effect of maternal
food
or multiple
micronutrient
supplementation on offspring systolic
blood
pressure
at
4.5
years old
(n=2335).
The
micronutrient intervention was also unrelated to
offspring
diastolic
blood
pressure,
but there was evidence that an early
invitation to
enter a
governmental
food
supplementation programme was associated with marginally
lower
diastolic
blood
pressure: 0.58mmHg (95% Cl: 0.06,1.11; P: 0.03). In this
setting,
randomisation to
receive counselling to promote exclusive
breast feeding
was not associated
with
offspring blood pressure at 4.5 years of age and
none of the interventions
were
associated with offspring kidney function, assessed as
ultrasound-obtained
volume
and glomerular filtration rate calculated
from
plasma
Cystatin C.
These data suggest that the maternal
diet during
pregnancy, at
least those
aspects
of intake that can be altered during supplementation trials,
may not
be
directly
relevant for the determination of offspring
blood
pressure.
Nutritional
exposures
during other stages of the life course may prove to
be
more
important