TY - JOUR
T1 - CHIPS-Child: Testing the developmental programming hypothesis in the offspring of the CHIPS trial
AU - the CHIPS-Child Study Group (Table S1)
AU - Magee, Laura A.
AU - Synnes, Anne R.
AU - von Dadelszen, Peter
AU - Hutfield, Anna M.
AU - Chanoine, Jean-Pierre
AU - Côté, Anne-Marie
AU - Devlin, Angela M.
AU - Dorling, Jon
AU - Gafni, Amiram
AU - Ganzevoort, Wessel
AU - Helewa, Michael E.
AU - Hutton, Eileen K.
AU - Koren, Gideon
AU - Lee, Shoo K.
AU - Mcarthur, Dawn
AU - Rey, Evelyne
AU - Robinson, Wendy P.
AU - Roseboom, Tessa J.
AU - Singer, Joel
AU - Wilson, Samantha
AU - Moutquin, Jean Marie
PY - 2018
Y1 - 2018
N2 - Objectives: As a follow-up to the CHIPS trial (Control of Hypertension In Pregnancy Study) of ‘less tight’ (versus ‘tight’) control of maternal blood pressure in pregnancy, CHIPS-Child investigated potential developmental programming of maternal blood pressure control in pregnancy, by examining measures of postnatal growth rate and hypothalamic-pituitary adrenal (HPA) axis activation. Methods: CHIPS follow-up was extended to 12 ± 2 months corrected post-gestational age for anthropometry (weight, length, head/waist circumference). For eligible children with consent for a study visit, we collected biological samples (hair/buccal samples) to evaluate HPA axis function (hair cortisol levels) and epigenetic change (DNA methylation analysis of buccal cells). The primary outcome was ‘change in z-score for weight’ between birth and 12 ± 2 mos. Secondary outcomes were hair cortisol and genome-wide DNA methylation status. Results: Of 683 eligible babies, 183 (26.8%) were lost to follow-up, 83 (12.2%) declined, 3 (0.4%) agreed only to ongoing contact, and 414 (60.6%) consented. 372/414 (89.9%) had weight measured at 12mos. In ‘less tight’ (vs. ‘tight’) control, the primary outcome was similar [−0.26 (−0.53, +0.01); p = 0.14, padjusted = 0.06]; median (95% confidence interval) hair cortisol (N = 35 samples) was lower [−496 (−892, −100) ng/g; p = 0.02], and buccal swab DNA methylation (N = 16 samples) was similar. No differences in growth rate could be demonstrated up to 5 years. Conclusions: Results demonstrate no compelling evidence for developmental programming of growth or the HPA axis. Clinicians should look to the clinical findings of CHIPS to guide practice. Researchers should seek to replicate these findings and extend outcomes to paediatric blood pressure and neurodevelopment.
AB - Objectives: As a follow-up to the CHIPS trial (Control of Hypertension In Pregnancy Study) of ‘less tight’ (versus ‘tight’) control of maternal blood pressure in pregnancy, CHIPS-Child investigated potential developmental programming of maternal blood pressure control in pregnancy, by examining measures of postnatal growth rate and hypothalamic-pituitary adrenal (HPA) axis activation. Methods: CHIPS follow-up was extended to 12 ± 2 months corrected post-gestational age for anthropometry (weight, length, head/waist circumference). For eligible children with consent for a study visit, we collected biological samples (hair/buccal samples) to evaluate HPA axis function (hair cortisol levels) and epigenetic change (DNA methylation analysis of buccal cells). The primary outcome was ‘change in z-score for weight’ between birth and 12 ± 2 mos. Secondary outcomes were hair cortisol and genome-wide DNA methylation status. Results: Of 683 eligible babies, 183 (26.8%) were lost to follow-up, 83 (12.2%) declined, 3 (0.4%) agreed only to ongoing contact, and 414 (60.6%) consented. 372/414 (89.9%) had weight measured at 12mos. In ‘less tight’ (vs. ‘tight’) control, the primary outcome was similar [−0.26 (−0.53, +0.01); p = 0.14, padjusted = 0.06]; median (95% confidence interval) hair cortisol (N = 35 samples) was lower [−496 (−892, −100) ng/g; p = 0.02], and buccal swab DNA methylation (N = 16 samples) was similar. No differences in growth rate could be demonstrated up to 5 years. Conclusions: Results demonstrate no compelling evidence for developmental programming of growth or the HPA axis. Clinicians should look to the clinical findings of CHIPS to guide practice. Researchers should seek to replicate these findings and extend outcomes to paediatric blood pressure and neurodevelopment.
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85050824141&origin=inward
U2 - https://doi.org/10.1016/j.preghy.2018.04.021
DO - https://doi.org/10.1016/j.preghy.2018.04.021
M3 - Article
C2 - 30527103
SN - 2210-7789
VL - 14
SP - 15
EP - 22
JO - Pregnancy Hypertension
JF - Pregnancy Hypertension
ER -