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Increased catecholamines and heart rate in children with low birth weight: perinatal contributions to sympathoadrenal
S Johansson1, M Norman, L Legnevall
1Department of Woman & Child Health, Karolinska Institutet, Stockholm, Sweden.
Insights
Children born preterm or small for gestational age show increased sympathoadrenal activity. This suggests altered cardiovascular regulation may increase hypertension risk later in life.
Area of Science:
- Pediatric cardiology
- Autonomic nervous system regulation
- Cardiovascular health
Background:
- Low birth weight is a known risk factor for adult cardiovascular disease.
- The specific mechanisms linking low birth weight to cardiovascular disease remain unclear.
- Perinatal stress is hypothesized to impact autonomic regulation of the cardiovascular system.
Purpose of the Study:
- To investigate the association between low birth weight (preterm birth and small for gestational age) and autonomic regulation in children.
- To assess catecholamine levels, heart rate, and blood pressure responses to stress in children with different birth weights.
Main Methods:
- A clinical study involving 105 children aged 9.6 years, divided into normal birth weight controls, small for gestational age (SGA), and preterm groups.
- Measurement of urinary dopamine, adrenaline, and noradrenaline.
- Assessment of heart rate and blood pressure at rest, during orthostatic testing, and after a mental stress test.
Main Results:
- Children born preterm and SGA exhibited significantly higher urinary catecholamine excretion compared to controls.
- Elevated resting and stress-induced heart rates were observed in both preterm and SGA groups versus controls.
- Heart rate positively correlated with urinary catecholamine levels (r=0.24-0.27, P<0.05).
- No significant differences in blood pressure were found between the groups under various conditions.
Conclusions:
- Preterm birth and fetal growth restriction are linked to heightened sympathoadrenal activity in childhood.
- Stress-induced increases in heart rate and urinary catecholamines indicate altered cardiovascular control programming.
- These findings suggest a potential predisposition to hypertension in adulthood for children with low birth weight.
Background:
Low birth weight is associated with cardiovascular disease. The underlying mechanisms are unknown. We hypothesized that perinatal stress alters autonomic regulation of the cardiovascular system. In this study, catecholamines, heart rate (HR) and blood pressure (BP) were measured in healthy children with low birth weight.
Methods:
This clinical study included 105 children (mean age 9.6 years) in three groups; born at term with normal birth weight (controls, n=37), born at term but small for gestational age (SGA, n=29) and born preterm (Preterm, n=39). Dopamine, adrenaline and noradrenaline were determined in urine. HR and BP were measured at rest, during an orthostatic test and after a mathematical mental stress test.
Results:
Children in the Preterm and SGA groups excreted higher levels of catecholamines when compared with controls. HR (mean [SD] values) were higher at rest and after mental stress in Preterm (at rest 76 [9] and after mental stress 82 [12] min(-1)) and in SGA (79 [8] and 82 [10]) when compared with controls (70 [9] and 75 [9]). HR correlated with urinary catecholamines (r=0.24-0.27, P<0.05). Blood pressures measured at rest, during orthostatic testing and after mental stress did not differ between the groups.
Conclusions:
Preterm birth and fetal growth restriction are associated with increased sympathoadrenal activity in childhood, as indicated by stress-induced increases in HR and urinary catecholamines. These findings suggest that the cardiovascular control is differently programmed in these children with possibly higher risk of developing hypertension in adulthood.
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