Maternal heart health may shape child development

Clinical takeaway: Consider maternal cardiovascular health during pregnancy as a potential signal for offspring developmental risk, especially when multiple Life’s Essential 8 factors are suboptimal.

Cardiovascular health in pregnancy may be a practical, modifiable marker of the intrauterine environment—and a way to identify children who may benefit from closer developmental surveillance.

In a cohort study published in JAMA Network Open, researchers analyzed 8238 mother-child pairs from the Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study in Japan. Maternal cardiovascular health (CVH) during pregnancy was assessed using Life’s Essential 8: diet, physical activity, nicotine exposure, sleep, BMI, blood lipids, blood glucose, and blood pressure. Children were screened for developmental delay at a mean age of 4.1 years using the Japanese Ages and Stages Questionnaire, Third Edition.

Developmental delay in at least one domain occurred in 8.8% of children born to mothers with high CVH, 12.1% with moderate CVH, and 16.8% with low CVH. Compared with high CVH, moderate CVH was associated with a 30% higher risk of developmental delay (risk ratio [RR], 1.30; 95% confidence interval [CI], 1.09-1.54), while low CVH was associated with a 62% higher risk (RR, 1.62; 95% CI, 1.11-2.36).

The association extended across all 5 developmental domains. The largest effect size was seen in the personal-social domain (RR for low vs high CVH, 2.23; 95% CI, 1.23-4.07), while the communication domain showed the smallest effect size (RR, 1.40; 95% CI, 0.69-2.85). Sensitivity analyses were generally consistent, and component-level analyses did not identify a single dominant driver, suggesting overall CVH may be the more clinically useful signal.

“Better maternal CVH during pregnancy was associated with a lower risk of offspring developmental delay at age 4 years,” the authors concluded. Because the outcome was based on screening rather than clinical diagnosis, findings should support risk awareness and follow-up—not deterministic counseling.

Source: Ohseto H, et al. 2026 June 23. JAMA Netw Open. Maternal Cardiovascular Health During Pregnancy and Offspring Developmental Delay