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Preterm birth may be a larger risk factor for increased blood pressure than intrauterine growth restriction
Emma Steen1,2, Anna-Karin Bonamy3, Mikael Norman2,4
1Department of Clinical Sciences, Lund University, Lund, Sweden.
Insights
Adolescents born very low birthweight appropriate for gestational age (VLBW-AGA) showed higher blood pressure (BP) during stress. Extremely preterm birth may pose a greater risk for elevated BP than growth restriction.
Area of Science:
- Pediatric Cardiology
- Neonatology
- Endocrinology
Background:
- Very low birthweight (VLBW) and prematurity are linked to increased hypertension risk.
- Understanding blood pressure (BP) regulation in VLBW adolescents is crucial.
Purpose of the Study:
- To compare BP and salivary cortisol responses to stress in adolescents born VLBW (appropriate for gestational age [AGA] and small for gestational age [SGA]) versus term-born controls.
Main Methods:
- Compared three groups: VLBW-AGA (n=30, mean 27 weeks), VLBW-SGA (n=19, mean 31 weeks), and term-born AGA controls (n=43).
- Measured BP three times before MRI; assessed salivary cortisol and stress before/after MRI in adolescents aged 12-17 years.
Main Results:
- VLBW-AGA adolescents maintained higher systolic BP (9-12 mmHg) compared to VLBW-SGA and controls.
- BP decreased with repeated measures in VLBW-SGA and controls, but not VLBW-AGA.
- No significant differences in salivary cortisol responses were observed between groups or sexes.
Conclusions:
- Dynamic BP responses to stress differ in adolescents born VLBW-AGA.
- Extremely preterm birth (VLBW-AGA) may be a more significant risk factor for elevated BP than intrauterine growth restriction (VLBW-SGA).
Aim:
Very low birthweight (VLBW) and prematurity have been associated with an increased risk of high blood pressure (BP). We compared BP and salivary cortisol responses to a stressful situation between adolescents with a VLBW and controls.
Methods:
We compared three groups aged 12-17 years: 30 born VLBW but appropriate for gestational age (AGA) at a mean of 27 weeks, 19 born VLBW but small for gestational age (SGA) at a mean of 31 weeks and 43 term-born AGA controls. Three consecutive BP measurements were performed before a magnetic resonance imaging (MRI) examination. Salivary cortisol and perceived stress were assessed before and after the MRI.
Results:
Systolic and diastolic BP decreased significantly for each repeated measurement in the VLBW-SGA group and controls, but remained unchanged in the VLBW-AGA group. The third systolic BP measurement was 9-12 mmHg higher in the VLBW-AGA group than the other groups (p < 0.05). There were no differences in salivary cortisol between the groups, before and after the MRI or between the sexes.
Conclusion:
Dynamic BP responses differed between adolescents born VLBW-AGA and the other groups, indicating that extremely preterm birth may be a larger risk factor for increased BP than intrauterine growth restriction.
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