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Low birth weight and cardiovascular risk factors at school age
António Guerra1, Carla Rego, Carla Vasconcelos
1Serviço de Pediatria, Hospital de São João, Faculdade de Medicina, Universidade do Porto, Porto, Portugal. ajmonicaguerra@mail.telepac.pt
Insights
Low birth weight newborns show higher blood pressure by school age, especially with greater weight gain. This highlights the importance of maternal health to reduce low birth weight and future cardiovascular disease risk.
Area of Science:
- Pediatric Nutrition
- Cardiovascular Epidemiology
- Fetal Programming
Background:
- Epidemiological studies link birth nutritional status to chronic diseases, particularly cardiovascular issues.
- Fetal programming suggests early life nutrition influences future disease risk, including diabetes and hypertension.
- Low birth weight (LBW) is a key concern for long-term health outcomes.
Purpose of the Study:
- To investigate the impact of birth nutritional status on blood pressure and lipid profiles in school-aged children.
- To evaluate the long-term effects of low birth weight on cardiovascular risk factors.
Main Methods:
- Prospective evaluation of 30 low birth weight (LBW) newborns and 26 appropriate for gestational age (AGA) newborns up to 84 months.
- Nutritional status assessed regularly; blood pressure and lipid profiles measured at 84 months per international guidelines.
Main Results:
- Catch-up growth observed in LBW group, with similar stature at 84 months compared to AGA group.
- LBW children with greater weight gain showed significantly higher diastolic blood pressure (p < 0.01).
- LBW group had lower apolipoprotein A levels (p < 0.05), but other lipid profiles were similar.
Conclusions:
- LBW newborns face increased cardiovascular disease risk due to higher blood pressure at school age.
- Greater weight gain in LBW individuals exacerbates this risk, independent of breastfeeding.
- Reducing LBW prevalence through improved maternal health and nutrition is crucial for public health.
Background:
Many epidemiological studies show a strong association between nutritional status at birth and later chronic diseases, particularly cardiovascular diseases. These results seem to confirm fetal programming regarding risk factors and future diseases such as diabetes, hypertension, cardiovascular disease and kidney dysfunction. The aim of the present study is to evaluate, in a group of low-birth-weight (LBW) newborns, the influence of nutritional status at birth on blood pressure and lipid profile at school age.
Methods:
A group of low birth weight newborns (n = 30) and a group with appropriate gestational age (AGA) (n = 26) were prospectively evaluated from birth up to 84 months of age. Nutritional status was evaluated at every observation and blood pressure and lipid profile were measured at 84 months according to international recommendations.
Results:
A catch-up growth was observed in the LBW group during the first two years of life, stature at 84 months being similar in both groups (AGA = -0.3 +/- 0.8 Z-score; LBW = -0.4 +/- 1.1 Z-score). When results are grouped according to weight gain between birth and 84 months of life, and taking account of breast-feeding duration, the LBW children show higher values, with significant differences in diastolic blood pressure between groups in those with greater weight gain (AGA = 88.8 +/- 5.8% of 50th percentile; LBW = 101.2 +/- 5.8% of 50th percentile; p < or = 0.01). Regarding lipid profile, no differences were found except for apolipoprotein A, with lower values in the LBW group (LBW = 125.6 +/- 4.1 mg/dl; AGA = 143.4 +/- 24.6 mg/dl; p < or = 0.05).
Conclusions:
Low birth weight newborns are at higher risk of future cardiovascular disease as they show higher blood pressure values compared to those with appropriate nutritional status at birth. These results are more evident in those individuals with greater weight gain, irrespective of breastfeeding duration. All efforts should be directed towards environmental factors that can negatively influence the health and nutritional status of pregnant women in order to reduce the prevalence of LBW newborns.
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