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Size at birth, infant growth, and blood pressure at three years of age

Mandy B Belfort1, Sheryl L Rifas-Shiman, Janet Rich-Edwards

  • 1Division of Newborn Medicine, Children's Hospital Boston, Boston, MA 02115, USA. mandy.belfort@childrens.harvard.edu

The Journal of Pediatrics
|November 24, 2007
PubMed

Insights

Rapid infant weight gain in the first 6 months is linked to higher early childhood systolic blood pressure (SBP). This association is stronger in babies born smaller, highlighting the importance of infant growth patterns for cardiovascular health.

Area of Science:

  • Pediatrics
  • Cardiovascular Health
  • Growth and Development

Background:

  • Infant growth patterns, specifically weight-for-length z-scores (WFL-z), are critical indicators of early development.
  • Understanding the long-term implications of infant growth on later health outcomes, such as blood pressure, is essential for preventative care.

Purpose of the Study:

  • To investigate the association between infant weight-for-length growth from birth to 6 months and systolic blood pressure (SBP) at 3 years of age.
  • To determine if birth size modifies the relationship between early growth and later SBP.

Main Methods:

  • Prospective cohort study of 530 children (Project Viva).
  • Measurements included birth length, 6-month weight and length, and 3-year SBP using standardized instruments and automated recorders.
  • Weight-for-length z-scores (WFL-z) were derived and analyzed using mixed-effects regression models.

Main Results:

  • A higher WFL-z at 6 months was associated with increased SBP at 3 years (1.0 mm Hg per z-score increment, adjusted for confounders and birth WFL-z).
  • Children with the lowest birth WFL-z and highest 6-month WFL-z had significantly higher SBP (5.5 mm Hg) compared to those with the highest birth and lowest 6-month WFL-z.
  • Mean SBP at 3 years was 91.7 (9.4) mm Hg.

Conclusions:

  • Accelerated weight-for-length gain during the first 6 months of life is a significant predictor of higher early childhood SBP.
  • This association is particularly pronounced in infants who were smaller at birth, suggesting a critical window for cardiovascular programming.
Abstract

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