The renin-angiotensin-aldosterone system in adolescent offspring born prematurely to mothers with preeclampsia.

ABSTRACT

HYPOTHESIS/INTRODUCTION: Preeclampsia is associated with alterations in the maternal renin-angiotensin-aldosterone system (RAAS), increased blood pressure (BP), and cardiovascular risk in the offspring. We hypothesized that preeclampsia is associated with alterations in the RAAS in the offspring that persist into adolescence. MATERIALS AND METHODS: We compared components of the circulating (n = 111) and renal (n = 160) RAAS in adolescents born prematurely with very low birth weight (VLBW) of preeclamptic (PreE) and normotensive (NoHTN) pregnancies. Multivariable linear regression was used to evaluate potential confounding and intermediate variables. Analyses were stratified by sex. RESULTS: Adjusting for race and antenatal steroid exposure, male offspring of PreE mothers had higher circulating aldosterone than those of NoHTN mothers (adjusted mean difference = 109; 95% confidence limits -9, 227 pmol/L). Further adjustment for current BMI attenuated this difference (adjusted mean difference 93; 95% confidence limits -30, 215 pmol/L). CONCLUSION: Among male preterm VLBW infants, maternal preeclampsia is associated with increased circulating aldosterone level in adolescence, which appears to be mediated in part by higher BMI.