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Size at birth and blood pressure: cross sectional study in 8-11 year old children
S J Taylor1, P H Whincup, D G Cook
1Department of Primary Care and Population Sciences, Royal Free Hospital School of Medicine, London. staylor@rfhsm.ac.uk
Insights
Birth weight is linked to higher systolic blood pressure in children, particularly girls. Other birth size measures did not show a clear association with later blood pressure in this study.
Area of Science:
- Pediatric Health
- Cardiovascular Epidemiology
- Fetal Development
Background:
- Childhood blood pressure is a key indicator of cardiovascular health.
- Fetal growth patterns may influence long-term health outcomes, including blood pressure.
- Understanding the relationship between birth size and childhood blood pressure is crucial for early intervention.
Purpose of the Study:
- To investigate the association between various fetal growth indicators at birth and blood pressure in children aged 8-11 years.
- To determine if sex influences the relationship between birth size and subsequent blood pressure.
- To explore the role of different neonatal measurements in predicting childhood blood pressure.
Main Methods:
- A cross-sectional survey of 3010 singleton children across 10 towns in England and Wales.
- Collection of physical measurements and birth weight data via parental questionnaires and hospital records.
- Measurement of systolic and diastolic blood pressure in children aged 8-11 years.
Main Results:
- Inverse association found between birth weight and systolic blood pressure (BP) after adjusting for current body size, particularly strong in girls.
- No significant link between birth weight and diastolic BP.
- Head circumference and placental weight were inversely associated with BP in girls; placental ratio was positively associated with BP in boys.
Conclusions:
- The association between birth weight and systolic BP was evident only in girls.
- No clear evidence that other birth size measures, potentially reflecting prenatal nutrition, predict offspring blood pressure.
- Findings highlight potential sex-specific influences of fetal growth on childhood blood pressure.
Objective:
To identify which patterns of fetal growth, represented by different measurements of size at birth, are associated with increased blood pressure in children aged 8-11 years.
Design And Setting:
School based, cross sectional survey conducted in 10 towns in England and Wales in 1994.
Subjects:
3010 singleton children (response rate 75%) with physical measurements and information on birth weight from parental questionnaires. Hospital birth records were examined for 1573.
Main Outcome Measures:
Systolic and diastolic blood pressure at age 8-11 years.
Results:
In the whole group birth weight was inversely related to systolic pressure (regression coefficient -1.48 mm Hg/kg; 95% confidence interval -2.20 to -0.76) after adjustment for current body size. There was no significant association between birth weight and diastolic pressure. The association with systolic pressure was much stronger in girls (-2.54 mm Hg/kg; -3.60 to -1.48) than in boys (-0.64 mm Hg/kg; -1.58 to 0.30), with a significant difference between the sexes (P = 0.006). Among the other neonatal measures, head circumference and placental weight were inversely associated with subsequent blood pressure in girls, and placental ratio (placental weight:birth weight) was positively associated with blood pressure in boys. Neither ponderal index at birth nor length:head circumference ratio was related to blood pressure in either sex.
Conclusions:
In these contemporary children the association between birth weight and blood pressure was apparent only in girls. There was no evidence that measures of size at birth, which may be related to nutrition at critical periods of pregnancy (thinness at birth or shortness in relation to head circumference), are related to blood pressure in the offspring.