Grant: Operating Grant

There is now solid evidence that a reduced rate of growth before birth is associated, in adulthood, with more cardiovascular disease (like heart attack or stroke). The information comes from different populations around the world, and is true even when babies are born with birthweight that is within the 'normal' range. At present, the 'Developmental Origins Hypothesis' provides the best explanation. In response to a decrease in nutrition during in utero life, the fetus makes changes to how he/she 'reads' his/her genes. These changes are permanent and after birth, set up the child's metabolism in a way that may be harmful in the long-term (e.g., predispose to diabetes or high blood pressure). CHIPS-Child is a follow-up study of CHIPS, a multicentre CIHR-funded randomised controlled trial that will recruit 1,028 women internationally (2008-14). CHIPS is designed to determine whether allowing blood pressure to be higher than normal during pregnancy may be better for the baby without increasing risk to the mother. CHIPS-Child is designed to determine whether the way that a mother's blood pressure is managed during pregnancy may have long-lasting effects on the child. Children will be seen at 12 months for basic body measurements, a painless swab of cells from the inside of their cheek, and a hair sample; mothers will complete a questionnaire about infant feeding practices and their years of education. Contact will be maintained with families on an annual basis, by mail, until CHIPS-Child concludes and the necessity of ongoing follow-up is determined. All women who have been enrolled in CHIPS so far are aware of the potential for follow-up through the current 'Information and Consent Form'. We anticipate that we will follow-up 626 children (313/group) to the age of 12 months. CHIPS-Child will help us to understand how therapies for the women during pregnancy may have long-lasting effects on the baby.