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Birth weight impacts on wave reflections in children and adolescents
Empar Lurbe1, Maria Isabel Torro, Eva Carvajal
1Pediatric Nephrology Unit, Department of Pediatrics, General Hospital, University of Valencia, Avda Tres Cruces s/n., 46014 Valencia, Spain. empar.lurbe@uv.es
Insights
Children with lower birth weights exhibit higher pulse wave reflection, indicating an aged large-vessel function. This early cardiovascular change may increase future cardiovascular risk.
Area of Science:
- Pediatric Cardiology
- Vascular Physiology
- Public Health
Background:
- Low birth weight is a known risk factor for adult cardiovascular disease.
- Early life factors can influence long-term cardiovascular health.
- Central aortic pressure and wave reflection are key indicators of vascular health.
Purpose of the Study:
- To investigate the relationship between birth weight and central aortic pressure and wave reflection in children and adolescents.
- To determine if lower birth weight is associated with altered large-vessel function in early life.
Main Methods:
- Study included 219 healthy children aged 7-18 years, categorized by birth weight.
- Radial artery pressure waveforms were recorded and analyzed using SphygmoCor software to estimate central aortic pressure.
- Augmentation index, a measure of pulse wave reflection, was calculated.
Main Results:
- Children with the lowest birth weights (<2.5 kg) showed significantly higher augmentation index compared to other groups.
- Lower birth weight was independently associated with higher augmentation index, even after adjusting for diastolic blood pressure.
- Factors such as short stature, low heart rate, and female gender also correlated with higher augmentation index.
Conclusions:
- Children born with lower birth weights exhibit an aged phenotype of large-vessel function.
- These early vascular alterations may contribute to the increased cardiovascular risk observed in individuals with low birth weight.
- Findings highlight the importance of early life conditions on long-term cardiovascular health.
Abstract:
The objective of the present study was to assess central aortic pressure and wave reflection in children and adolescents at different birth weights. Two hundred nineteen healthy children (126 girls), from 7 to 18 years of age (mean, 11.3 years) and born at term after a normotensive pregnancy, were included. The subjects were divided according to birth weight: <2.5 kg, from 2.5 to 2.999 kg, from 3.0 to 3.5 kg, and >3.5 kg. Pressure waveforms were recorded from the radial artery of the wrist, and the waveform data were then processed by the SphygmoCor radial/aortic transform software module to produce the estimated aortic pressure waveform. Augmentation index, an estimate of the pulse wave reflection, was significantly higher in children with the lowest birth weights compared with the other birth weight groups. In a multiple regression analysis, short stature, low heart rate, female gender, and lower birth weight had independent significant inverse correlations to the augmentation index when adjusted for diastolic blood pressure (R2=0.21). In summary, the results showed a relatively aged phenotype of large-vessel function in the children with the lowest birth weights. These early alterations may be amplified throughout life and may contribute to the increased cardiovascular risk associated with low birth weight.