{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,6]],"date-time":"2026-02-06T03:11:55Z","timestamp":1770347515147,"version":"3.49.0"},"reference-count":55,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,8,7]],"date-time":"2025-08-07T00:00:00Z","timestamp":1754524800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,8,7]],"date-time":"2025-08-07T00:00:00Z","timestamp":1754524800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100001332","name":"Council for Scientific and Industrial Research, South Africa","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001332","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Cardiovasc Disord"],"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Background<\/jats:title>\n            <jats:p>Previous studies have shown the effects of teratogen exposure <jats:italic>in utero<\/jats:italic> on the vascular system, but its direct and indirect effects are still questionable. Therefore, this study explored the effects of potential mediators of teratogen exposure on carotid intima\u2013media thickness (cIMT) and flow-mediated dilation (FMD).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>This study was conducted between January 2022 and August 2024 in Cape Town, South Africa, and included 307 adolescents (aged 10\u201314) and their mothers. Anthropometry data, lipid profiles, systolic (SBP) and diastolic blood pressure (DBP), physical activity and maternal health behaviours were obtained. Vascular measurements (left and right cIMT and brachial artery FMD) were obtained via ultrasound, which included analysing the peak artery diameter separately. Statistical analyses were performed via SPSS<jats:sup>\u00ae<\/jats:sup> version 29, and mediation analyses were conducted via PROCESS Macros.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>The cohort included a control group (<jats:italic>n<\/jats:italic>\u2009=\u2009105), tobacco-exposed individuals (<jats:italic>n<\/jats:italic>\u2009=\u2009115), dual-exposed individuals (tobacco and alcohol) (<jats:italic>n<\/jats:italic>\u2009=\u200973), and alcohol-exposed individuals (<jats:italic>n<\/jats:italic>\u2009=\u200914). A significant positive correlation was observed between alcohol exposure duration and LcIMT (rho\u2009=\u20090.531, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05), and a strong negative correlation was observed with peak diameter (rho=-0.788, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), with a very strong correlation in males (<jats:italic>r<\/jats:italic>=-0.894, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05). The duration of alcohol exposure significantly affected LcIMT (<jats:italic>p<\/jats:italic>\u2009=\u20090.0468) after adjusting for body mass index (BMI), SBP and DBP. However, brachial artery (BA) peak diameter was not significantly associated with the duration of alcohol consumption during pregnancy after the adjustment for age, SBP or BA baseline diameter.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>Increased BMI and SBP may contribute to a reduced peak diameter in adolescents exposed to alcohol, potentially indicating lower FMD in adulthood. Further studies should elucidate the biological mechanisms involved through long-term prospective studies.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1186\/s12872-025-05010-1","type":"journal-article","created":{"date-parts":[[2025,8,7]],"date-time":"2025-08-07T04:06:34Z","timestamp":1754539594000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Carotid intima\u2013media thickness and endothelial function in adolescents exposed to alcohol consumption and cigarette smoking in utero: a mediation analysis"],"prefix":"10.1186","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2154-5379","authenticated-orcid":false,"given":"Tammy","family":"Hartel","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aamer","family":"Sandoo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andr\u00e9","family":"Oelofse","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jul\u00e9y","family":"De Smidt","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,8,7]]},"reference":[{"key":"5010_CR1","doi-asserted-by":"publisher","first-page":"1","DOI":"10.4103\/ijpvm.IJPVM_246_16","volume":"8","author":"A Davoudi-Kiakalayeh","year":"2017","unstructured":"Davoudi-Kiakalayeh A, Mohammadi R, Pourfathollah AA, Siery Z, Davoudi-Kiakalayeh S. Alloimmunization in thalassemia patients: new insight for healthcare. Int J Prev Med. 2017;8:1\u20135.","journal-title":"Int J Prev Med"},{"key":"5010_CR2","doi-asserted-by":"publisher","first-page":"49","DOI":"10.1016\/j.alcohol.2017.03.001","volume":"62","author":"K Dukes","year":"2017","unstructured":"Dukes K, Tripp T, Willinger M, Odendaal H, Elliott AJ, Kinney HC, et al. Drinking and smoking patterns during pregnancy: development of group-based trajectories in the safe passage study. Alcohol. 2017;62:49\u201360.","journal-title":"Alcohol"},{"key":"5010_CR3","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1136\/bmjsem-2022-001336","volume":"8","author":"D Dolley","year":"2022","unstructured":"Dolley D, Walter C, Du Randt R, P\u00fchse U, Bosma J, Aerts A, et al. Clustered cardiovascular disease risk among children aged 8\u201313 years from lower socioeconomic schools in gqeberha, South Africa. BMJ Open Sport Exerc Med. 2022;8:1\u20138.","journal-title":"BMJ Open Sport Exerc Med"},{"key":"5010_CR4","doi-asserted-by":"crossref","unstructured":"Hartel TC, Oelofse A, De Smidt JJA. Vascular effects, potential pathways and mediators of fetal exposure to alcohol and cigarette smoking during pregnancy: a narrative review. Int J Environ Res Public Health. 2023;20(14):6398.","DOI":"10.3390\/ijerph20146398"},{"key":"5010_CR5","doi-asserted-by":"publisher","first-page":"545","DOI":"10.1080\/03602532.2019.1679169","volume":"51","author":"B Le Dar\u00e9","year":"2019","unstructured":"Le Dar\u00e9 B, Lagente V, Gicquel T. Ethanol and its metabolites: update on toxicity, benefits, and focus on immunomodulatory effects. Drug Metab Rev. 2019;51:545\u201361.","journal-title":"Drug Metab Rev"},{"key":"5010_CR6","first-page":"1","volume":"3","author":"M Kozakova","year":"2016","unstructured":"Kozakova M, Palombo C. Vascular ultrasound and cardiovascular risk assessment. Austin J Vasc Med. 2016;3:1\u20139.","journal-title":"Austin J Vasc Med"},{"key":"5010_CR7","doi-asserted-by":"publisher","first-page":"926","DOI":"10.1152\/japplphysiol.01113.2014","volume":"119","author":"ND Hopkins","year":"2015","unstructured":"Hopkins ND, Dengel DR, Stratton G, Kelly AS, Steinberger J, Zavala H, et al. Age and sex relationship with flow-mediated dilation in healthy children and adolescents. J Appl Physiol. 2015;119:926\u201333.","journal-title":"J Appl Physiol"},{"key":"5010_CR8","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1111\/ijpo.12863","volume":"17","author":"KN Cajachagua-Torres","year":"2022","unstructured":"Cajachagua-Torres KN, El Marroun H, Reiss IKM, Santos S, Jaddoe VWV. Foetal tobacco and cannabis exposure, body fat and cardio-metabolic health in childhood. Pediatr Obes. 2022;17:1\u201311.","journal-title":"Pediatr Obes"},{"key":"5010_CR9","doi-asserted-by":"publisher","first-page":"619","DOI":"10.1016\/j.annepidem.2018.06.010","volume":"28","author":"DR Stevens","year":"2018","unstructured":"Stevens DR, Malek AM, Laggis C, Hunt KJ. In utero exposure to tobacco smoke, subsequent cardiometabolic risks, and metabolic syndrome among U.S. Adolescents. Ann Epidemiol. 2018;28:619\u2013e6241.","journal-title":"Ann Epidemiol"},{"key":"5010_CR10","doi-asserted-by":"publisher","first-page":"2446","DOI":"10.1093\/eurheartj\/ehr174","volume":"32","author":"JG Ayer","year":"2011","unstructured":"Ayer JG, Belousova E, Harmer JA, David C, Marks GB, Celermajer DS. Maternal cigarette smoking is associated with reduced high-density lipoprotein cholesterol in healthy 8-year-old children. Eur Heart J. 2011;32:2446\u201353.","journal-title":"Eur Heart J"},{"key":"5010_CR11","doi-asserted-by":"publisher","first-page":"e037806","DOI":"10.1161\/JAHA.124.037806","volume":"14","author":"M Liu","year":"2025","unstructured":"Liu M, Soon EY, Lange K, Juonala M, Kerr JA, Liu R, et al. Maternal smoking intensity during pregnancy and early adolescent cardiovascular health. J Am Heart Assoc. 2025;14:e037806.","journal-title":"J Am Heart Assoc"},{"key":"5010_CR12","first-page":"1","volume":"0","author":"MP Kose","year":"2024","unstructured":"Kose MP, Piskinpasa ME, Hacioglu Y, Karabag T. The relationship of visceral adiposity with endothelial functions and subclinical atherosclerosis in obese individuals. Rom J Intern Med. 2024;0:1\u201320.","journal-title":"Rom J Intern Med"},{"key":"5010_CR13","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/1479-5876-11-263","volume":"11","author":"M El Assar","year":"2013","unstructured":"El Assar M, Ruiz de Adana JC, Angulo J, Pindado Mart\u00ednez ML. Hern\u00e1ndez Mat\u00edas A, Rodr\u00edguez-Ma\u00f1as L. Preserved endothelial function in human obesity in the absence of insulin resistance. J Transl Med. 2013;11:1\u201311.","journal-title":"J Transl Med"},{"issue":"4","key":"5010_CR14","doi-asserted-by":"publisher","first-page":"347","DOI":"10.1093\/alcalc\/agq028","volume":"45","author":"N Toda","year":"2010","unstructured":"Toda N, Ayajiki K. Vascular actions of nitric oxide as affected by exposure to alcohol. Alcohol Alcoholism. 2010;45(4):347\u201355.","journal-title":"Alcohol Alcoholism"},{"key":"5010_CR15","doi-asserted-by":"publisher","first-page":"1","DOI":"10.3389\/fphys.2018.00602","volume":"9","author":"P Rodr\u00edguez-Rodr\u00edguez","year":"2018","unstructured":"Rodr\u00edguez-Rodr\u00edguez P, Ramiro-Cortijo D, Reyes-Hern\u00e1ndez CG, L\u00f3pez de Pablo AL, Carmen Gonz\u00e1lez M, Arribas SM. Implication of oxidative stress in fetal programming of cardiovascular disease. Front Physiol. 2018;9:1\u201313.","journal-title":"Front Physiol"},{"key":"5010_CR16","doi-asserted-by":"publisher","first-page":"3740","DOI":"10.1080\/14767058.2019.1692337","volume":"34","author":"J De Smidt","year":"2019","unstructured":"De Smidt J, Odendaal HJ, Nel DG, Nolan H, C DP, Brink LT, et al. In utero teratogen exposure and cardiometabolic risk in 5-year-old children: a prospective pediatric study. J Maternal-Fetal Neonatal Med. 2019;34:3740\u20139.","journal-title":"J Maternal-Fetal Neonatal Med"},{"key":"5010_CR17","doi-asserted-by":"publisher","first-page":"1039","DOI":"10.1007\/s00431-006-0376-9","volume":"166","author":"T Gunes","year":"2007","unstructured":"Gunes T, Koklu E, Yikilmaz A, Ozturk MA, Akcakus M, Kurtoglu S, et al. Influence of maternal smoking on neonatal aortic intima-media thickness, serum IGF-I and IGFBP-3 levels. Eur J Pediatr. 2007;166:1039\u201344.","journal-title":"Eur J Pediatr"},{"key":"5010_CR18","doi-asserted-by":"publisher","first-page":"346","DOI":"10.1016\/j.ajog.2003.12.040","volume":"191","author":"MR Andersen","year":"2004","unstructured":"Andersen MR, Walker LR, Stender S. Reduced endothelial nitric oxide synthase activity and concentration in fetal umbilical veins from maternal cigarette smokers. Am J Obstet Gynecol. 2004;191:346\u201351.","journal-title":"Am J Obstet Gynecol"},{"key":"5010_CR19","doi-asserted-by":"publisher","first-page":"116","DOI":"10.1111\/acer.14970","volume":"47","author":"JA Kable","year":"2023","unstructured":"Kable JA, Mehta PK, Rashid F, Coles CD. Path analysis of the impact of prenatal alcohol on adult vascular function. Alcohol Clin Exp Res. 2023;47:116\u201326.","journal-title":"Alcohol Clin Exp Res"},{"key":"5010_CR20","doi-asserted-by":"publisher","unstructured":"Matjuda EN, Engwa GA, Anye SNC, Nkeh\u2013Chungag BN, Goswami N. Cardiovascular risk factors and their relationship with endothelial dysfunction in rural and urban South African children [preprint]. Research Square. 2020.\u00a0https:\/\/doi.org\/10.21203\/rs.3.rs-54162\/v1.","DOI":"10.21203\/rs.3.rs-54162\/v1"},{"key":"5010_CR21","doi-asserted-by":"publisher","first-page":"448","DOI":"10.1017\/S2040174417000265","volume":"8","author":"C Yzydorczyk","year":"2017","unstructured":"Yzydorczyk C, Armengaud JB, Peyter AC, Chehade H, Cachat F, Juvet C, et al. Endothelial dysfunction in individuals born after fetal growth restriction: cardiovascular and renal consequences and preventive approaches. J Dev Orig Health Dis. 2017;8:448\u201364.","journal-title":"J Dev Orig Health Dis"},{"key":"5010_CR22","first-page":"139","volume":"176","author":"VD Naik","year":"2016","unstructured":"Naik VD, Davis-Anderson K, Subramanian K, Lunde-Young R, Nemec MJ, Ramadoss J. HHS public access. J Obstet Gynaecol (Lahore). 2016;176:139\u201348.","journal-title":"J Obstet Gynaecol (Lahore)"},{"key":"5010_CR23","doi-asserted-by":"publisher","first-page":"1832","DOI":"10.1111\/acer.12431","volume":"38","author":"K Subramanian","year":"2014","unstructured":"Subramanian K, Naik VD, Sathishkumar K, Yallampalli C, Saade GR, Hankins GD, et al. Chronic binge alcohol exposure during pregnancy impairs rat maternal uterine vascular function. Alcohol Clin Exp Res. 2014;38:1832\u20138.","journal-title":"Alcohol Clin Exp Res"},{"key":"5010_CR24","doi-asserted-by":"publisher","first-page":"1727","DOI":"10.1111\/acer.14121","volume":"43","author":"JC Cook","year":"2019","unstructured":"Cook JC, Lynch ME, Coles CD. Association analysis: fetal alcohol spectrum disorder and hypertension status in children and adolescents. Alcohol Clin Exp Res. 2019;43:1727\u201333.","journal-title":"Alcohol Clin Exp Res"},{"key":"5010_CR25","doi-asserted-by":"publisher","first-page":"204","DOI":"10.1159\/000252973","volume":"97","author":"R Morley","year":"2010","unstructured":"Morley R, Dwyer T, Hynes KL, Cochrane J, Ponsonby AL, Parkington HC, et al. Maternal alcohol intake and offspring pulse wave velocity. Neonatology. 2010;97:204\u201311.","journal-title":"Neonatology"},{"key":"5010_CR26","unstructured":"Dean A, Island R, Heart BF, Hospital HF, Island R. ACSM\u2019s guideline for exercise testing and prescription. 10th ed. Philadelphia: Wolters Kluwer Healt. In: American College of Sports Medicine; 2018."},{"key":"5010_CR27","unstructured":"Statistics South Africa. Census 2022: Cape Town trends and changes. Pretoria: Stats SA; 2022. Available from: https:\/\/www.statssa.gov.za."},{"issue":"9","key":"5010_CR28","doi-asserted-by":"publisher","first-page":"634","DOI":"10.2471\/blt.16.181636","volume":"94","author":"W Johnson","year":"2016","unstructured":"Johnson W, Onuma O, Owolabi M, Sachdev AS. Stroke: a global response is needed. Bull World Health Organ. 2016;94(9):634\u2013A634. https:\/\/doi.org\/10.2471\/blt.16.181636.","journal-title":"Bull World Health Organ"},{"key":"5010_CR29","unstructured":"World Health Organization. BMI-for-age girls: WHO growth standards (z-scores). Geneva: WHO; 2007. Available from: https:\/\/www.who.int\/childgrowth\/standards\/BMI_for_age\/en\/."},{"key":"5010_CR30","unstructured":"World Health Organization. BMI-for-age boys: WHO growth standards (z-scores). Geneva: WHO; 2007. Available from: https:\/\/www.who.int\/childgrowth\/standards\/BMI_for_age\/en\/."},{"key":"5010_CR31","doi-asserted-by":"publisher","first-page":"290","DOI":"10.1159\/000343145","volume":"34","author":"PJ Touboul","year":"2012","unstructured":"Touboul PJ, Hennerici MG, Meairs S, Adams H, Amarenco P, Bornstein N, et al. Mannheim carotid intima-media thickness and plaque consensus (2004-2006-2011). Cerebrovasc Dis. 2012;34:290\u20136.","journal-title":"Cerebrovasc Dis"},{"key":"5010_CR32","doi-asserted-by":"publisher","first-page":"2534","DOI":"10.1093\/eurheartj\/ehz350","volume":"40","author":"DHJ Thijssen","year":"2019","unstructured":"Thijssen DHJ, Bruno RM, Van Mil ACCM, Holder SM, Faita F, Greyling A, et al. Expert consensus and evidence-based recommendations for the assessment of flow-mediated dilation in humans. Eur Heart J. 2019;40:2534\u201347.","journal-title":"Eur Heart J"},{"key":"5010_CR33","doi-asserted-by":"publisher","first-page":"2","DOI":"10.1152\/ajpheart.00471.2010","volume":"300","author":"DHJ Thijssen","year":"2011","unstructured":"Thijssen DHJ, Black MA, Pyke KE, Padilla J, Atkinson G, Harris RA, et al. Assessment of flow-mediated dilation in humans: a methodological and physiological guideline. Am J Physiol Heart Circ Physiol. 2011;300:2\u201312.","journal-title":"Am J Physiol Heart Circ Physiol"},{"key":"5010_CR34","doi-asserted-by":"crossref","unstructured":"Juonala M, Viikari JSA, K\u00e4h\u00f6nen M, Laitinen T, Taittonen L, Loo BM et al. Alcohol consumption is directly associated with carotid intima-media thickness in Finnish young adults. The cardiovascular risk in young Finns study. Atherosclerosis. 2009;204(2):e93\u20138.","DOI":"10.1016\/j.atherosclerosis.2008.11.021"},{"key":"5010_CR35","doi-asserted-by":"crossref","unstructured":"Jukic I, Kos M, Stupin A, Mihaljevic Z, Nad T, Damasek M, et al. Flow-mediated dilation of brachial artery in children and adolescents with essential arterial hypertension. J Hypertens. 2024;42(Suppl 1):e101.","DOI":"10.1097\/01.hjh.0001020308.45525.65"},{"key":"5010_CR36","doi-asserted-by":"publisher","first-page":"719","DOI":"10.1007\/s00431-010-1328-y","volume":"170","author":"C Lamotte","year":"2011","unstructured":"Lamotte C, Iliescu C, Libersa C, Gottrand F. Increased intima-media thickness of the carotid artery in childhood: a systematic review of observational studies. Eur J Pediatr. 2011;170:719\u201329.","journal-title":"Eur J Pediatr"},{"key":"5010_CR37","doi-asserted-by":"publisher","first-page":"593","DOI":"10.1146\/annurev.psych.58.110405.085542","volume":"58","author":"DP Mackinnon","year":"2007","unstructured":"Mackinnon DP, Fairchild AJ, Fritz MS. Mediation analysis. Annu Rev Psychol. 2007;58:593\u2013614.","journal-title":"Annu Rev Psychol"},{"key":"5010_CR38","doi-asserted-by":"publisher","first-page":"441","DOI":"10.1055\/s-0032-1304825","volume":"29","author":"S Iwashima","year":"2012","unstructured":"Iwashima S, Ishikawa T, Akira O, Itou H. Association of abdominal aortic wall thickness in the newborn with maternal factors. Am J Perinatol. 2012;29:441\u20138.","journal-title":"Am J Perinatol"},{"key":"5010_CR39","doi-asserted-by":"crossref","unstructured":"Turan H, Me\u015fe T, Doksoz O, Turan V. Assessment of carotid artery Intima-Media thickness and lipid profile in term neonates born to smoking mothers. Iran J Pediatr. 2021;31(6):e112313.","DOI":"10.5812\/ijp.112313"},{"key":"5010_CR40","doi-asserted-by":"publisher","first-page":"133","DOI":"10.1001\/jamapediatrics.2023.5351","volume":"178","author":"Y Meng","year":"2024","unstructured":"Meng Y, Sharman JE, Koskinen JS, Juonala M, Viikari JSA, Buscot MJ, et al. Blood pressure at different life stages over the early life course and intima-media thickness. JAMA Pediatr. 2024;178:133\u201341.","journal-title":"JAMA Pediatr"},{"key":"5010_CR41","doi-asserted-by":"publisher","first-page":"1118","DOI":"10.1093\/ajh\/hpz107","volume":"32","author":"C Arnold","year":"2019","unstructured":"Arnold C, Ullrich C, Wensing M, Pfinder M. Prenatal alcohol exposure and the associated risk of elevated blood pressure: a cross-sectional analysis of 3- to 17-year-olds in Germany. Am J Hypertens. 2019;32:1118\u201325.","journal-title":"Am J Hypertens"},{"key":"5010_CR42","doi-asserted-by":"publisher","first-page":"257","DOI":"10.1016\/S0735-1097(01)01746-6","volume":"39","author":"MC Corretti","year":"2002","unstructured":"Corretti MC, Anderson TJ, Benjamin EJ, Ms C, Celermajer D, Charbonneau F, et al. Guidelines for the ultrasound assessment of endothelial-dependent flow-mediated vasodilation of the brachial artery A report of the international brachial artery reactivity task force. J Am Coll Cardiol. 2002;39:257\u201365.","journal-title":"J Am Coll Cardiol"},{"key":"5010_CR43","doi-asserted-by":"publisher","first-page":"1264","DOI":"10.1161\/01.CIR.103.9.1264","volume":"103","author":"CPM Leeson","year":"2001","unstructured":"Leeson CPM, Kattenhorn M, Morley R, Lucas A, Deanfield JE. Impact of low birth weight and cardiovascular risk factors on endothelial function in early adult life. Circulation. 2001;103:1264\u20138.","journal-title":"Circulation"},{"key":"5010_CR44","doi-asserted-by":"crossref","unstructured":"Engan B, Engan M, Greve G, Volls\u00e6ter M, Hufthammer KO, Leirgul E. Vascular Endothelial Function Assessed by Flow-Mediated Vasodilatation in Young Adults Born Very Preterm or With Extremely Low Birthweight: A Regional Cohort Study. Front Pediatr. 2021;9:1\u201313.","DOI":"10.3389\/fped.2021.734082"},{"key":"5010_CR45","doi-asserted-by":"publisher","first-page":"142","DOI":"10.1097\/GRF.0000000000000414","volume":"62","author":"K Dejong","year":"2019","unstructured":"Dejong K, Olyaei A, Lo JO. Alcohol use in pregnancy. Clin Obstet Gynecol. 2019;62:142\u201355.","journal-title":"Clin Obstet Gynecol"},{"key":"5010_CR46","doi-asserted-by":"publisher","first-page":"91","DOI":"10.1111\/j.1440-1681.2009.05342.x","volume":"37","author":"HC Parkington","year":"2010","unstructured":"Parkington HC, Coleman HA, Wintour EM, Tare M. Prenatal alcohol exposure: implications for cardiovascular function in the fetus and beyond. Clin Exp Pharmacol Physiol. 2010;37:91\u20138.","journal-title":"Clin Exp Pharmacol Physiol"},{"key":"5010_CR47","doi-asserted-by":"publisher","first-page":"2591","DOI":"10.1113\/jphysiol.2013.262873","volume":"592","author":"HC Parkington","year":"2014","unstructured":"Parkington HC, Kenna KR, Sozo F, Coleman HA, Bocking A, Brien JF, et al. Maternal alcohol consumption in pregnancy enhances arterial stiffness and alters vasodilator function that varies between vascular beds in fetal sheep. J Physiol. 2014;592:2591\u2013603.","journal-title":"J Physiol"},{"key":"5010_CR48","doi-asserted-by":"publisher","first-page":"414","DOI":"10.1152\/ajpheart.00127.2012","volume":"303","author":"J Ramadoss","year":"2012","unstructured":"Ramadoss J, Magness RR. Vascular effects of maternal alcohol consumption. Am J Physiol Heart Circ Physiol. 2012;303:414\u201321.","journal-title":"Am J Physiol Heart Circ Physiol"},{"key":"5010_CR49","doi-asserted-by":"publisher","first-page":"1116","DOI":"10.1177\/1933719117734317","volume":"25","author":"AM Tobiasz","year":"2018","unstructured":"Tobiasz AM, Duncan JR, Bursac Z, Sullivan RD, Tate DL, Dopico AM, et al. The effect of prenatal alcohol exposure on fetal growth and cardiovascular parameters in a baboon model of pregnancy. Reprod Sci. 2018;25:1116\u201323.","journal-title":"Reproductive Sci"},{"key":"5010_CR50","doi-asserted-by":"crossref","unstructured":"Padovan JC, Dourado TMH, Pimenta GF, Bruder-Nascimento T, Tirapelli CR. Reactive oxygen species are central mediators of vascular dysfunction and hypertension induced by ethanol consumption. Antioxidants. 2023;12(10):1813.","DOI":"10.3390\/antiox12101813"},{"key":"5010_CR51","doi-asserted-by":"publisher","first-page":"3740","DOI":"10.1080\/14767058.2019.1692337","volume":"34","author":"JJA De Smidt","year":"2021","unstructured":"De Smidt JJA, Odendaal HJ, Nel DG, Nolan H, Du Plessis C, Brink LT, et al. In utero teratogen exposure and cardiometabolic risk in 5-year-old children: a prospective pediatric study. J Maternal-Fetal Neonatal Med. 2021;34:3740\u20139.","journal-title":"J Maternal-Fetal Neonatal Med"},{"key":"5010_CR52","first-page":"45","volume":"69","author":"J Hamu\u0142ka","year":"2018","unstructured":"Hamu\u0142ka J, Zieli\u0144ska MA, Ch\u0105dzy\u0144ska K. The combined effects of alcohol and tobacco use during pregnancy on birth outcomes. Rocz Panstw Zakl Hig. 2018;69:45\u201354.","journal-title":"Rocz Panstw Zakl Hig"},{"key":"5010_CR53","first-page":"36","volume":"24","author":"AM Li","year":"2018","unstructured":"Li AM, Celermajer DS, Chan MH, Sung RY, Woo KS. Reference range for brachial artery flow-mediated dilation in healthy Chinese children and adolescents. Hong Kong Med J. 2018;24:36\u20138.","journal-title":"Hong Kong Med J"},{"key":"5010_CR54","doi-asserted-by":"publisher","first-page":"1469","DOI":"10.1161\/HYPERTENSIONAHA.120.15754","volume":"77","author":"SM Holder","year":"2021","unstructured":"Holder SM, Bruno RM, Shkredova DA, Dawson EA, Jones H, Hopkins ND, et al. Reference intervals for brachial artery Flow-Mediated dilation and the relation with cardiovascular risk factors. Hypertension. 2021;77:1469\u201380.","journal-title":"Hypertension"},{"key":"5010_CR55","doi-asserted-by":"publisher","first-page":"1","DOI":"10.3389\/fendo.2020.574216","volume":"11","author":"L Pacifico","year":"2020","unstructured":"Pacifico L, Perla FM, Tromba L, Carbotta G, Lavorato M, Pierimarchi P, et al. Carotid extra-media thickness in children: relationships with cardiometabolic risk factors and endothelial function. Front Endocrinol (Lausanne). 2020;11:1\u20138.","journal-title":"Front Endocrinol (Lausanne)"}],"container-title":["BMC Cardiovascular Disorders"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12872-025-05010-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12872-025-05010-1\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12872-025-05010-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,8]],"date-time":"2025-09-08T22:18:48Z","timestamp":1757369928000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmccardiovascdisord.biomedcentral.com\/articles\/10.1186\/s12872-025-05010-1"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,7]]},"references-count":55,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["5010"],"URL":"https:\/\/doi.org\/10.1186\/s12872-025-05010-1","relation":{},"ISSN":["1471-2261"],"issn-type":[{"value":"1471-2261","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,7]]},"assertion":[{"value":"11 January 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"30 June 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"7 August 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The study was conducted according to the guidelines of the Declaration of Helsinki and approved by the Biomedical Research Ethics Committee of the University of the Western Cape (Ethics Reference Number: BM21\/9\/16). Informed consent was obtained from both the woman or legal guardian and child involved in the study. Written consent was also obtained from both the mother or legal guardian and child before they participated in the study.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"590"}}