PhD student: Briana DeStaffan
Title: Maternal blood pressure trajectories during pregnancy and fetal growth: social determinants, critical windows, and clinical implications
Supervisors: Barbara Heude & Wen Lun Yuan
Doctoral school: ED 393 Epidemiology and Biomedical Information Sciences, Université Paris Cité
Promotion: 2023
Funding: EHESP
Thesis abstract:
Hypertensive disorders of pregnancy (chronic hypertension, gestational hypertension, pre-eclampsia) are among the leading causes of maternal and fetal morbidity and mortality in high-income countries. They pose a risk to women’s long-term cardiovascular health, as well as to the fetus in the form of intrauterine growth restriction (IUGR). IUGR also increases the risk of adverse cardiometabolic health for the child in later life.
Further research is needed from the beginning of pregnancy to understand the determinants, mechanisms, and dynamics of maternal blood pressure during pregnancy, for effective prevention of hypertensive disorders and their consequences.
The aim of this thesis is therefore to examine cardiovascular health during pregnancy using an approach which considers the variability of blood pressure according to gestational age. This thesis uses data from the EDEN cohort (https://eden.vjf.inserm.fr).
The thesis is structured around the following three axes:
- Investigate the associations between individual and contextual socio-economic indicators and blood pressure during pregnancy, as well as the mediating role of behavioral factors
- Identify critical windows of exposure to blood pressure variations during pregnancy in relation to fetal growth, as well as specific adverse effects related to IUGR
- Evaluate the clinical implications of modifying blood pressure reference thresholds to achieve greater sensitivity in the diagnosis of hypertensive disorders and the prevention of IUGR
