Association of Maternal Hypertensive Disorders in Pregnancy and Offspring Kidney Function from Adolescence into Young Adulthood

Background: Maternal hypertension (HTN) during pregnancy is associated with significant health complications for the mother and offspring. Little research exists on its effect on offspring kidney function into young adulthood. Our aim is to estimate the association of maternal HTN during pregnancy with offspring kidney function in adolescence and young adulthood. Methods: This is a secondary longitudinal analysis of data collected in a prospective cohort study of individuals born with very low or extremely low birth weight (birth weight <1500 g). Participants were assessed at 14–15 and 19–23 years old. Blood and first-morning urine samples were collected. We estimated the glomerular filtration rate (eGFR) using the original creatinine-based Schwartz equation in adolescents and the CKD-EPI 2021 creatinine-cystatin C equation in young adults. We calculated the albumin-to-creatinine ratio at both time points. We estimated the relationships with multivariable generalized linear models informed by directed acyclic graphs. Results: Of the 213 included participants, 113 (53%) were female, 89 (42%) were Black, and 79 (37%) were exposed to maternal HTN. The mean eGFR was 130.2 mL/min/1.73 m2 in adolescence (n=124) and 168.7 mL/min/1.73 m2 in young adulthood (n=159). The median ACR was 5.3 mg/g in adolescence and 3.1 mg/g in young adulthood. Kidney function in adolescence was associated with kidney function in young adulthood (eGFR adjusted β 0.48 mL/min/1.73 m2, 95% CL 0.21–0.75; ACR adjusted β 0.19 mg/g, 95% CL 0.15–0.24). There was no significant association between maternal HTN and kidney function in both adolescence and young adulthood. Conclusion: We found no significant association between maternal HTN in pregnancy and offspring kidney function in adolescence and young adulthood. The next step for this project is to perform a causal mediation analysis to estimate the direct effect of maternal HTN in pregnancy on young adult kidney function and the indirect effect mediated by adolescent kidney function. Funding: NIDDK Support - NIDDK Support, NIDDK Support