DISCUSSION
cardiovascular disease, prematurity, inflammation, adiposity, arterial stiffness
CARDIOVASCULAR DISEASE, INFLAMMATION, CARDIOVASCULAR MORBIDITY, ADIPOSITY, ARTERIAL STIFFNESS
This study reports higher SBP, DBP, corresponding central BPs, PP, and PWV among 8–12-year-old PE children compared with matched non-PE children, but no major differences in body anthropometrics, body composition or different laboratory parameters of cardiovascular risk. There was a higher proportion of SBP nondipping among PE and SBP and PP-values were pronounced among early-onset PE. Both maternal gestational SBP and child prematurity factors explained PE-related differences in child SBP at follow-up. Child PP differences between PE and non-PE, however, remained significant after adjustments with gestational SBP and prematurity. Child PP was associated with child adiposity at follow-up. Central and peripheral PWVs were higher among PE and related with child age, anthropometrics, and office SBP at follow-up, but not with gestational maternal SBP or child prematurity factors. There was no influence of sex on PE children's BP or PWV. Taken together, these results show adverse BP profiles predicted by maternal gestational BP and child prematurity as well as arterial stiffness predicted by child anthropometrics and BP at follow-up in children following PE. These findings are consistent with an early emerging cardiovascular risk profile in children following PE and consistent with reported cardiovascular morbidity and mortality in this population later during adulthood [Our office and ambulatory SBP and DBP results confirm recent meta-analyses [To our understanding, PP has not been previously assessed in PE offspring. Due to limited effects of PE on DBP, analyzing PP provided the opportunity to assess more subtle PE-related differences in SBP. Consistent with this, PPs were higher among PE compared with non-PE children. The difference in PP between the groups was relatively strongly influenced by similar maternal and child factors as for SBP. Our analyses show an independent difference in PP between PE and non-PE groups when adjusting for maternal gestational SBP and child prematurity factors. PP was, furthermore, strongly related with not only BMI but also with different adiposity measures at follow-up suggesting a link between BP and adiposity. As PP is like SBP strongly related with cardiovascular disease long-term [Strong relations between maternal BPs and child BPs might be explained by shared genetic, in-utero, or postnatal lifestyle pathways [Our late-onset PE children displayed higher PWVs consistent with arterial stiffness. Another recent study showed elevated PWVs among 2–10-year-old children, but confined to early-onset PE children [Strengths of the study include the prospective design, the large sample size with an age matched control group, comprehensive background information for both index pregnancy and follow-up as well as comprehensive assessment of BP. The study is limited, like most prospective cohort studies, by loss to follow-up in the original FINNPEC cohort, and some selection bias cannot be fully ruled out. Postnatal child growth data was not available.In conclusion, significantly higher SBP, DBP, corresponding central BPs, PP, and PWV, but no major differences in body anthropometrics, body composition or blood glucose, lipids or inflammation indicating cardiovascular risk are found among PE children at mean 11 years-of-age. PE-related BP is associated with both maternal gestational systolic BP and child prematurity, whereas arterial stiffness is determined by child anthropometrics and BP at follow-up. Child BP changes are pronounced in the early-onset form of PE.