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Birth weight and blood pressure: cross sectional and longitudinal relations in childhood
P Whincup1, D Cook, O Papacosta
1University Department of Public Health, Royal Free Hospital School of Medicine, London.
Insights
Lower birth weight is linked to higher blood pressure in children, with a faster rise in systolic blood pressure for those with lower birth weight, especially girls. This highlights birth weight as a key early life factor influencing childhood blood pressure.
Area of Science:
- Pediatric Health
- Cardiovascular Epidemiology
- Developmental Origins of Health and Disease
Background:
- Childhood blood pressure is a critical indicator of cardiovascular health.
- Early life factors, including birth weight, may influence long-term blood pressure trajectories.
- Understanding these relationships is crucial for early identification and prevention of hypertension.
Purpose of the Study:
- To investigate the cross-sectional and longitudinal associations between birth weight and blood pressure in children.
- To determine if birth weight or placental ratio is a more significant predictor of childhood blood pressure.
- To explore potential sex differences in the relationship between birth weight and blood pressure development.
Main Methods:
- Cross-sectional study of 1511 primary school children aged 9-11 years.
- Longitudinal analysis included 549 children with prior measurements at 5-7 years.
- Blood pressure, birth weight (maternal recall), and placental weight (birth records) were assessed.
Main Results:
- Lower birth weight was inversely associated with both systolic and diastolic blood pressure at 9-11 years, even after adjusting for height and BMI.
- Systolic blood pressure increased more rapidly between ages 5-7 and 9-11 years in children with lower birth weight, particularly in girls.
- Placental weight showed an inverse relationship with blood pressure, but the placental ratio was not significantly associated.
Conclusions:
- Birth weight is a more critical early-life determinant of childhood blood pressure than placental ratio.
- The findings suggest an "amplification" effect, where the association between birth weight and blood pressure becomes more pronounced over time, especially in girls.
- Interventions targeting individuals with low birth weight may be important for preventing childhood hypertension.
Objective:
To examine cross sectional and longitudinal relations between birth weight and blood pressure in childhood.
Design:
Cross sectional study of primary school children aged 9-11 years, with analysis in relation to previous measurements at 5-7 years in a subgroup.
Setting:
20 primary schools in Guildford and Carlisle.
Subjects:
1511 children measured at 9-11 years (response rate 79%), including 549 who had been measured at 5-7 years.
Main Outcome Measures:
Blood pressure at 9-11 years, change in blood pressure between 5-7 and 9-11 years, birth weight (based on maternal recall), and placental weight (based on birth records).
Results:
At 9-11 years birth weight was inversely related both to systolic blood pressure (regression coefficient -2.80 mm Hg/kg; 95% confidence interval -3.84 to -1.76) and to diastolic blood pressure (regression coefficient -1.42 mm Hg/kg; -2.14 to -0.70) once current height and body mass index were taken into account. Placental weight was inversely related to blood pressure after adjustment for current height and body mass index but placental ratio (placental weight to birth weight) was unrelated to blood pressure. Between 5-7 and 9-11 years systolic blood pressure rose more rapidly in children of lower birth weight (regression coefficient -1.71 mm Hg/kg; -3.35 to -0.07). This effect seemed to be stronger in girls.
Conclusions:
Birth weight rather than placental ratio is the early life factor most importantly related to blood pressure in childhood. The results support the possibility of "amplification" of the relation between birth weight and blood pressure, particularly in girls.