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Analysis of 'sensitive' periods of fetal and child growth
Xun Zhang1, Kate Tilling2, Richard M Martin2,3
1Department of Pediatrics, McGill University Faculty of Medicine, Montreal, Canada.
Insights
Childhood weight gain, particularly during adolescence, is linked to higher blood pressure. Standardized measures of weight gain reveal sensitive periods for cardiometabolic disease risk.
Area of Science:
- Pediatrics
- Cardiology
- Public Health
Background:
- Birth weight and infant weight gain are recognized risk factors for adult cardiometabolic diseases.
- Understanding sensitive periods of growth is crucial for predicting later health outcomes.
- This study investigates methods to quantify weight gain and its association with blood pressure.
Purpose of the Study:
- To compare analytical approaches for quantifying weight gain during different life stages.
- To determine the magnitude of associations between weight gain and blood pressure at age 16.
- To identify sensitive developmental periods for weight gain's impact on blood pressure.
Main Methods:
- Utilized data from a birth cohort study with repeated weight measurements from birth to 16 years.
- Compared four analytical methods: z-scores of weight, weight gain velocity, standardized residuals, and absolute weight gain velocity.
- Assessed the relationship between standardized weight gain and blood pressure at age 16.
Main Results:
- Standardized weight gain (by age and sex) and regression-based residuals provided more consistent results than absolute weight gain velocity.
- Standardized weight gain showed a positive association with blood pressure at age 16 across all postnatal periods.
- The association between weight gain and blood pressure was strongest during adolescence (11.5-16 years).
Conclusions:
- Standardizing weight and weight gain by age and sex, or using conditional weight standardized residuals, accurately reflects relative growth.
- Adolescence is a more sensitive period for the effects of relative weight gain on subsequent blood pressure compared to earlier childhood.
- These findings highlight the importance of monitoring relative weight gain during adolescence for cardiovascular health.
Background:
Birth weight and weight gain in infancy and early childhood are commonly studied as risk factors for later cardiometabolic diseases. In this study, we explore methods for quantifying weight gain during different age periods and for comparing the magnitude of the associations with later blood pressure.
Methods:
Based on data from a birth cohort study nested within a large cluster-randomized trial with repeated measures of weight from birth to 16 years of age, we compared the results of four analytic approaches to assess sensitive periods of growth in relation to blood pressure at age 16 years.
Results:
Approaches based on z-scores of weight or weight gain velocity (both standardized for age and sex) or on regression-based conditional weight standardized residuals yielded more coherent results than an approach based on absolute weight gain velocity. Weight gain standardized by sex and age was positively associated with blood pressure at 16 years at all postnatal age periods, but the magnitude of association was larger during adolescence (11.5-16 years) than during earlier intervals (0-3 months, 3-12 months, 1-6.5 years or 6.5-11.5 years).
Conclusions:
Standardization of weight and weight gain by age and sex, or regression-based standardized residuals based on conditional weight, reflects relative gain and thus accounts for the rapid weight gains normally observed in early infancy and puberty. Adolescence appears to be a more sensitive period for relative weight gain effects on later blood pressure than earlier periods, even those of similar duration.