Maternal cotyledons at birth predict blood pressure in childhood
Open accessAbstract
INTRODUCTION: A small placental surface at birth has been shown to be associated with the development of hypertension in later life. In this study we extend this observation by looking at the relationship between the number of placental cotyledons and blood pressure in childhood. Because the number of cotyledons is correlated with the surface area, we hypothesized that fewer cotyledons would be associated with higher blood pressure. METHODS: The Alspac study is a longitudinal study of 13,971 children born in Bristol. Their placentas were stored in formalin. We photographed the placentas of a sample of the children and related the number of maternal cotyledons to their blood pressure levels at age 9 years. RESULTS: Contrary to our hypothesis, a greater number of maternal cotyledons was associated with higher blood pressure. Among boys, a greater number of cotyledons was associated with higher systolic and diastolic pressure but not with higher pulse pressure. Diastolic pressure rose by 2.2 mmHg (95% CI 0.6 to 3.7, p = 0.007) for every 10 additional cotyledons. Among girls, a greater number of cotyledons was associated with higher systolic pressure and pulse pressure but not with higher diastolic pressure. Pulse pressure rose by 2.7 mmHg (1.1-4.3, p < 0.001) for every 10 additional cotyledons. These associations were little changed by adjustment for placental surface area. CONCLUSION: Our study has shown that a large number of maternal cotyledons is associated with raised blood pressure in childhood. The associations differ in the two sexes.
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In the ALSPAC study of 13,971 births in Bristol UK, the number of lobes on the maternal surface of the placenta was related to the blood pressure of the children at age 9 years.
“A study of placentas of children in the longitudinal Alspac study of 13,971 births in Bristol UK, showed the number of lobes on the maternal surface was related to the blood pressure of the children at age 9 years (24).”
From Placental Origins of Chronic Disease (2016) · cites this paper as [24]
Increasing lobe number (range 4 to 40) was associated with higher blood pressures in both boys and girls.
“Increasing lobe number (range 4 to 40) was associated with higher blood pressures in both boys and girls.”
From Placental Origins of Chronic Disease (2016) · cites this paper as [24]
Adjustment for placental surface area did not change the relationships between placental lobe number and blood pressure.
“Adjustment for placental surface area, a powerful determinant of hypertension in adult men, did not change the relationships.”
From Placental Origins of Chronic Disease (2016) · cites this paper as [24]
Among boys, the number of lobes was directly associated with higher systolic and diastolic pressure, but not with an increased pulse pressure.
“However, among boys, the number of lobes was directly associated with higher systolic and diastolic pressure, but not with an increased pulse pressure.”
From Placental Origins of Chronic Disease (2016) · cites this paper as [24]
In boys, diastolic pressure rose by 2.2 mmHg (95% CI 0.6 to 3.7, p = 0.007) for every 10 additional lobes.
“In that group, diastolic pressure rose by 2.2 mmHg (95% CI 0.6 to 3.7, p =0.007) for every 10 additional lobes.”
From Placental Origins of Chronic Disease (2016) · cites this paper as [24]
In girls, a greater number of lobes was associated with higher systolic pressure and pulse pressure, but not with higher diastolic pressure.
“A greater number of lobes was associated with higher systolic pressure and pulse pressure, but not with higher diastolic pressure, in girls.”
From Placental Origins of Chronic Disease (2016) · cites this paper as [24]
In girls, pulse pressure rose by 2.7 mmHg (95% CI 1.1 to 4.3, p < 0.001) for every 10 additional lobes.
“Pulse pressure rose by 2.7 mmHg (1.1 to 4.3, p<0.001) for every 10 additional lobes.”
From Placental Origins of Chronic Disease (2016) · cites this paper as [24]
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- Authors
- Barker, D., Osmond, C., Grant, S., Thornburg, K. L., Cooper, C., Ring, S., & Davey-Smith, G.
- Affiliations
- Oregon Health & Science University (US)
- Southampton General Hospital (GB)
- University of Bristol (GB)
- Corresponding author
- Barker, D.
- Venue
- Placenta
- Publisher
- Elsevier BV
- Published
- 2013-08
- Volume
- 34
- Issue
- 8
- Pages
- 672-675
- ISSN
- 0143-4004 (ISSN-L)
- PMC
- PMC3733167
- OpenAlex
- W2059780404
- Cited by
- 41
- References
- 12
- Citations by year
- 2026: 2 · 2025: 1 · 2024: 3 · 2023: 4 · 2022: 6 · 2021: 5 · 2020: 4 · 2019: 1 · 2018: 2 · 2017: 3 · 2016: 3 · 2015: 3 · 2014: 2 · 2013: 2
- FWCI
- 3.73
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Placenta (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- ePrints Soton (University of Southampton) (acceptedVersion)
- Bristol Research (University of Bristol) (submittedVersion)
- Funders
- UK Medical Research Council (74882)
- Wellcome Trust (076467)
- University of Bristol
- Medical School and the MRC Lifecourse Epidemiology Unit
- Topics
- Health Sciences › Medicine › Obstetrics and Gynecology › Pregnancy and preeclampsia studies
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Birth, Development, and Health
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
- Keywords
- placental cotyledons, placental surface area, childhood blood pressure, hypertension, sex differences, ALSPAC cohort, placental morphology
- MeSH terms
- Adult, Birth Weight, Blood Pressure, Child, Female, Humans, Infant, Newborn, Longitudinal Studies, Male, Placenta, Pregnancy
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