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Relationship between birthweight and blood pressure in childhood
1Department of Pediatrics, University of Alberta, Edmonton, Canada. vyiu@mercury.uah.ualberta.ca
Insights
Lower birthweight in term infants is linked to higher blood pressure by age 7, even after accounting for current weight and height. This suggests birthweight is a factor in developing essential hypertension.
Area of Science:
- Pediatrics
- Cardiovascular Health
- Public Health
Background:
- Existing research indicates an inverse correlation between birthweight and later-life blood pressure.
- Childhood blood pressure is a critical indicator of cardiovascular health.
- Essential hypertension is a multifactorial condition influenced by various factors.
Purpose of the Study:
- To investigate the relationship between birthweight and blood pressure in childhood within a North American population.
- To determine if birthweight is an independent predictor of blood pressure at age 7.
Main Methods:
- Retrospective analysis of 2,958 births from the Providence, RI, cohort of the Collaborative Perinatal Project.
- Utilized univariate and multivariate analytic methods, including linear regression.
- Subdivided term infants into small-for-gestational-age (SGA) and large-for-gestational-age (LGA) groups.
Main Results:
- A significant inverse relationship was observed between birthweight and systolic blood pressure (SBP) at age 7.
- Follow-up weight and height were the strongest predictors of both SBP and diastolic blood pressure (DBP).
- For every 1-kg decrease in birthweight, SBP increased by 1.3 mm Hg and DBP by 0.6 mm Hg at age 7.
Conclusions:
- Birthweight, relative to gestational age, appears to be an independent contributor to blood pressure levels in childhood.
- These findings suggest birthweight may play a role in the multifactorial etiology of essential hypertension.
- Early life factors like birthweight warrant consideration in strategies for hypertension prevention.
Abstract:
Studies have shown an inverse relationship between birthweight and blood pressure in later life. The objective of this study is to analyze the relationship between birthweight and blood pressure in childhood in a North American-based population. Data on 2,958 births with follow-up at 7 years of age from the Providence, RI, cohort of the Collaborative Perinatal Project of the National Institute of Neurological Diseases and Stroke were retrospectively analyzed using univariate and multivariate analytic methods. Bivariate analysis of the total cohort showed a direct relationship between follow-up weight at age 7 years and birthweight (r = 0.24; P < 0.001) and follow-up weight with systolic (SBP) and diastolic blood pressure (DBP; r = 0.33; P < 0.001 and r = 0.22; P < 0.001, respectively). On multivariate analysis, follow-up weight and height were the strongest predictors of SBP and DBP. There was also a significant inverse relationship between birthweight and SBP. A cohort of term infants (n = 2,561) was subdivided into birthweight-for-gestational-age groupings to further evaluate the effects of birthweight on blood pressure. Small-for-gestational-age (SGA) infants were markedly smaller at age 7 years than those large-for-gestational-age (LGA; 21 +/- 4 kg v 26 +/- 4 kg; P < 0.01). Despite the direct association between follow-up weight and blood pressure, the mean blood pressure did not differ between SGA (103/58 mm Hg) and LGA patients (103/59 mm Hg). To assess whether birthweight was an independent predictor of blood pressure, blood pressures were predicted using linear regression equations. For every 1-kg decrease in birthweight in term infants, SBP at 7 years increased by 1.3 mm Hg and DBP by 0.6 mm Hg. In conclusion, controlling for weight and height in term infants at 7 years of age has an inverse linear effect on blood pressure. This suggests that birthweight in relation to gestation may be a contributor to the multifactorial cause of essential hypertension.