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Obstetrician-Assessed Maternal Health at Pregnancy Predicts Offspring Future Health

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  • Debbie A Lawlor
  • Susan Morton
  • G David Batty
  • Sally Macintyre
  • Heather Clark
  • George Davey Smith

Abstract

Background: We aimed to examine the association between obstetrician assessment of maternal physical health at the time of pregnancy and offspring cardiovascular disease risk. Methods and Principal Findings: We examined this association in a birth cohort of 11,106 individuals, with 245,000 person years of follow-up. We were concerned that any associations might be explained by residual confounding, particularly by family socioeconomic position. In order to explore this we used multivariable regression models in which we adjusted for a range of indicators of socioeconomic position and we explored the specificity of the association. Specificity of association was explored by examining associations with other health related outcomes. Maternal physical health was associated with cardiovascular disease: adjusted (socioeconomic position, complications of pregnancy, birthweight and childhood growth at mean age 5) hazard ratio comparing those described as having poor or very poor health at the time of pregnancy to those with good or very good health was 1.55 (95%CI: 1.05, 2.28) for coronary heart disease, 1.91 (95%CI: 0.99, 3.67) for stroke and 1.57 (95%CI: 1.13, 2.18) for either coronary heart disease or stroke. However, this association was not specific. There were strong associations for other outcomes that are known to be related to socioeconomic position (3.61 (95%CI: 1.04, 12.55) for lung cancer and 1.28 (95%CI:1.03, 1.58) for unintentional injury), but not for breast cancer (1.10 (95%CI:0.48, 2.53)). Conclusions and Significance: These findings demonstrate that a simple assessment of physical health (based on the appearance of eyes, skin, hair and teeth) of mothers at the time of pregnancy is a strong indicator of the future health risk of their offspring for common conditions that are associated with poor socioeconomic position and unhealthy behaviours. They do not support a specific biological link between maternal health across her life course and future risk of cardiovascular disease in her offspring.

Suggested Citation

  • Debbie A Lawlor & Susan Morton & G David Batty & Sally Macintyre & Heather Clark & George Davey Smith, 2007. "Obstetrician-Assessed Maternal Health at Pregnancy Predicts Offspring Future Health," PLOS ONE, Public Library of Science, vol. 2(8), pages 1-7, August.
    • Handle: RePEc:plo:pone00:0000666
    DOI: 10.1371/journal.pone.0000666
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    References listed on IDEAS

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    1. Patrick Royston, 2004. "Multiple imputation of missing values," Stata Journal, StataCorp LP, vol. 4(3), pages 227-241, September.
    2. Lawlor, D.A. & Frankel, S. & Shaw, M. & Ebrahim, S. & Smith, G.D., 2003. "Smoking and Ill health: Does lay epidemiology explain the failure of smoking cessation programs among deprived populations?," American Journal of Public Health, American Public Health Association, vol. 93(2), pages 266-270.
    3. Lawlor, D.A. & Clark, H. & Leon, D.A., 2007. "Associations between childhood intelligence and hospital admissions for unintentional injuries in adulthood: The Aberdeen children of the 1950s cohort study," American Journal of Public Health, American Public Health Association, vol. 97(2), pages 291-297.
    4. Lawlor, D.A. & Ronalds, G. & Macintyre, S. & Clark, H. & Leon, D.A., 2006. "Family socioeconomic position at birth and future cardiovascular disease risk: Findings from the aberdeen children of the 1950s cohort study," American Journal of Public Health, American Public Health Association, vol. 96(7), pages 1271-1277.
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