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Weight Gain and Blood Pressure in Toddlers Born Very Preterm
Jeannie Rodriguez1, Ira Adams-Chapman, Olivia Affuso
1Jeannie Rodriguez, PhD, RN, APRN, was a PhD Student, School of Nursing, University of Alabama at Birmingham. She is now Assistant Research Professor, Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia. Ira Adams-Chapman, MD, MPH, is Associate Professor, School of Medicine, Emory University, and Clinical Director, Developmental Progress Clinic, Atlanta, Georgia. Olivia Affuso, PhD, is Associate Professor, University of Alabama at Birmingham School of Public Health. Andres Azuero, PhD, is Associate Professor, University of Alabama at Birmingham School of Nursing. Charles A. Downs, PhD, RN, ACNP-BC, FAAN, is Associate Professor, University of Miami School of Nursing and Health Sciences, Florida. Anne Turner-Henson, PhD, RN, FAAN, is Professor, retired, University of Alabama at Birmingham School of Nursing. Marti Rice, PhD, RN, FAAN, is Professor, University of Alabama at Birmingham School of Nursing.
Insights
Rapid weight gain in toddlers born preterm is linked to elevated blood pressure, a potential precursor to adult hypertension and cardiometabolic disease. Further research is needed to confirm these findings in larger populations.
Area of Science:
- Pediatrics
- Cardiovascular Health
- Endocrinology
Background:
- Preterm birth is a known risk factor for later hypertension and cardiometabolic disease.
- Mechanisms linking preterm birth to cardiovascular issues are not fully understood.
- Rapid early childhood weight gain may contribute to elevated blood pressure, potentially mediated by cortisol.
Purpose of the Study:
- To investigate the relationship between early postnatal weight gain and blood pressure in very preterm infants.
- To explore the potential mediating role of cortisol in this association.
Main Methods:
- Cross-sectional pilot study.
- Convenience sample of 36 toddlers born very preterm.
- Analysis of postnatal weight gain, blood pressure, and cortisol levels.
Main Results:
- Majority of participants experienced rapid weight gain in the first year.
- Elevated diastolic blood pressure readings were common in toddlers.
- Weight gain showed a medium effect size association with diastolic blood pressure.
- Cortisol did not mediate the relationship between weight gain and blood pressure.
Conclusions:
- Elevated blood pressure in toddlers born very preterm is concerning and may predict future cardiovascular disease.
- Rapid early weight gain appears to be a significant factor in developing hypertension in this population.
- Further validation in larger cohorts is essential.
Background:
Preterm birth is a risk factor for elevated blood pressure in childhood and the development of hypertension and cardiometabolic disease in adulthood; however, mechanisms for the development of both are poorly understood. Rapid weight gain early in childhood may serve as a driver directly and indirectly through cortisol levels found to be elevated in early childhood in individuals born preterm.
Objectives:
The objective of this pilot study was to examine the effect sizes of the relationships between weight gain and blood pressure in toddlers born very preterm. A secondary aim was to note any mediating effect of cortisol on the relationships between weight gain and blood pressure.
Methods:
A cross-sectional design with a convenience sample of 36 toddlers who were born very preterm was used to examine the relationships between postnatal weight gain, cortisol, and blood pressure at follow-up.
Results:
Many of the participants experienced rapid weight gain in the first 12 months of life. Mean systolic and diastolic readings were 94 and 56.6, respectively. Diastolic blood pressure readings were obtained from 23 participants, and the majority were elevated. Weight gain was associated with diastolic blood pressure with a medium effect size. A mediating role with cortisol was not supported.
Discussion:
Although findings need to be validated in a larger sample, the blood pressure elevations in this sample were alarming. If readings continue to amplify as these children age, the fact that elevations are already present during the toddler period could indicate more significant cardiovascular disease in adulthood for this population. Rapid weight gain in early life may be a driver for elevated blood pressure even during early childhood in individuals born preterm.
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