Related Experiment Videos
Ambulatory blood pressure in 12-year-old children born small for gestational age
Eero Rahiala1, Sirpa Tenhola, Esko Vanninen
1Department of Pediatrics, Kuopio University Hospital and University of Kuopio, Kuopio, Finland. eero.rahiala@hus.fi
Insights
Children born small for gestational age did not show higher blood pressure at age 12. However, adjusted for body mass index, systolic blood pressure was higher in this group, indicating current body size is a key factor.
Area of Science:
- Pediatrics
- Cardiovascular Health
- Developmental Biology
Background:
- Low birth weight is linked to elevated blood pressure later in life.
- Previous studies had limited data on children born small for gestational age (SGA).
- Ambulatory blood pressure in normal birth weight children has been previously evaluated.
Purpose of the Study:
- To evaluate 24-hour ambulatory blood pressure in term-born children who were small for gestational age (SGA) compared to appropriate for gestational age (AGA) peers.
- To investigate the relationship between birth weight, current body mass index (BMI), and blood pressure in these groups up to age 12.
Main Methods:
- Prospective case-control study from birth to age 12.
- Recruited 50 term-born SGA children and 50 term-born AGA children.
- Measured 24-hour ambulatory blood pressure and current body mass index.
Main Results:
- No significant differences in mean systolic or diastolic 24-hour ambulatory blood pressure between SGA and AGA children.
- Systolic blood pressure in SGA children was higher after adjusting for current BMI (3.90 mm Hg difference).
- Current body mass index was the sole determinant of the systolic blood pressure difference between the groups; birth weight showed no direct association.
Conclusions:
- While impaired fetal growth may relate to later blood pressure, by age 12, differences between SGA and AGA children are primarily influenced by current body size.
- Current BMI is a more significant factor than birth weight in determining blood pressure differences in 12-year-old SGA versus AGA children.
- Further research is needed to understand the long-term cardiovascular implications of SGA, considering the impact of adiposity.
Abstract:
An association between low birth weight and subsequent elevated blood pressure has been demonstrated in a large number of studies, but the number of subjects born small for gestational age in these studies has been negligible. The inverse relationship between birth weight and blood pressure in children has been evaluated previously with an ambulatory blood pressure device, but only in children with normal birth weights. In this prospective case-control study from birth to the age of 12, we evaluated the ambulatory blood pressures in 50 children born at term but small for gestational age and in 50 full-term children born appropriate for gestational age. Children born small for gestational age had similar mean+/-SD systolic (117.5+/-8.5 mm Hg versus 115.3+/-7.4 mm Hg, P=0.221), and diastolic (69.2+/-5.3 mm Hg versus 67.3+/-4.4 mm Hg, P=0.075) 24-hour ambulatory blood pressure compared with the values of the children born appropriate for gestational age. However, 24-hour systolic blood pressure in the small-for-gestational-age children was higher (3.90 mm Hg; 95% confidence interval, 0.65 to 7.15) after adjusting for current body mass index. The difference in current body mass index was the only determinant for the difference in systolic blood pressure between the groups. Birth weight had no direct association with the blood pressure values. Impaired fetal growth may have a relationship with higher later blood pressure, but in 12-year-old children, blood pressure differences between small for gestational age and appropriate for gestational age children are much more dependent on current body size.