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Blood pressure levels in childhood: probing the relative importance of birth weight and current size

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Abstract

Several studies have reported data supporting the idea that an impaired intrauterine environment that deprives the fetus of optimal nutrient delivery results in the predisposition of the fetus to experience cardiovascular and metabolic dysfunction in later life. However, contradictory data still exist. Our purpose was to investigate the effects of both birth weight and weight gain on the risk for high blood pressure levels in 6- to 10-year-old children. This cross-sectional study included 739 children divided into quartiles of birth weight. The mean values of both systolic and diastolic pressure were significantly different between quartiles of birth weight, with increasing blood pressure values as the birth weight decreased (P < 0.001). Covariance analysis adjusting for gender, prematurity, and body mass index (BMI) showed that both systolic and diastolic pressure remained greater in the lowest than in the highest birth weight quartile. Separating those with low and normal birth weight demonstrated that the risk of childhood hypertension was significantly higher among children with low birth weight and current obesity (odds ratio [OR]: 5.0, confidence interval [CI]: 3.3 to 16.1; P = 0.023). The inverse association between birth weight and blood pressure levels appears to be programmed during fetal life, while weight gain during childhood adds to this risk.

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References

  1. Barker DJ (1994) Mothers, babies and disease in later life. BMJ Publishing Group, London

    Google Scholar 

  2. Barker DJ (1999) The fetal origins of type 2 diabetes mellitus. Ann Intern Med 130:322–324

    PubMed  CAS  Google Scholar 

  3. Barker DJ (2002) Fetal programming of coronary heart disease. Trends Endocrinol Metab 13:364–368. doi:10.1016/S1043-2760(02)00689-6

    Article  PubMed  CAS  Google Scholar 

  4. Barker DJ (2006) Commentary: birthweight and coronary heart disease in a historical cohort. Int J Epidemiol 35:886–897. doi:10.1093/ije/dyl151

    Article  PubMed  Google Scholar 

  5. Barker DJ, Gluckman PD, Godfrey KM et al (1993) Fetal nutrition and cardiovascular disease in adult life. Lancet 341:938–941. doi:10.1016/0140-6736(93)91224-A

    Article  PubMed  CAS  Google Scholar 

  6. Falkner B, Hulman S, Kushner H (2004) Effect of birth weight on blood pressure and body size in early adolescence. Hypertension 43:203–207. doi:10.1161/01.HYP.0000109322.72948.24

    Article  PubMed  CAS  Google Scholar 

  7. Forrester TE, Wilks RJ, Bennett FI et al (1996) Fetal growth and cardiovascular risk factors in Jamaican schoolchildren. BMJ 312:156–160

    PubMed  CAS  Google Scholar 

  8. Franco MC, Christofalo DM, Sawaya AL et al (2006) Effects of low birth weight in 8- to 13-year-old children: implications in endothelial function and uric acid levels. Hypertension 48:45–50. doi:10.1161/01.HYP.0000223446.49596.3a

    Article  PubMed  CAS  Google Scholar 

  9. Franco MC, Kawamoto EM, Gorjão R et al (2007) Biomarkers of oxidative stress and antioxidant status in children born small for gestational age: evidence of lipid peroxidation. Pediatr Res 62:204–208. doi:10.1203/PDR.0b013e3180986d04

    Article  PubMed  CAS  Google Scholar 

  10. Franco MC, Higa EM, D’Almeida V et al (2007) Homocysteine and nitric oxide are related to blood pressure and vascular function in small-for-gestational-age children. Hypertension 50:396–402. doi:10.1161/HYPERTENSIONAHA.107.091223

    Article  PubMed  CAS  Google Scholar 

  11. Franco MC, Casarini DE, Carneiro-Ramos MS et al (2008) Circulating renin–angiotensin system and catecholamines in childhood: is there a role for birthweight. Clin Sci (Lond) 114:375–380. doi:10.1042/CS20070284

    CAS  Google Scholar 

  12. Gupta P, Narang M, Banerjee BD et al (2004) Oxidative stress in term small for gestational age neonates born to undernourished mothers: a case control study. BMC Pediatr 20:4–14

    Google Scholar 

  13. Hales CN, Barker DJ (2001) The thrifty phenotype hypothesis. Br Med Bull 60:5–20. doi:10.1093/bmb/60.1.5

    Article  PubMed  CAS  Google Scholar 

  14. Hemachandra AH, Howards PP, Furth SL et al (2007) Birth weight, postnatal growth, and risk for high blood pressure at 7 years of age: results from the Collaborative Perinatal Project. Pediatrics 119:e1264–e1270. doi:10.1542/peds.2005-2486

    Article  PubMed  Google Scholar 

  15. Hinchliffe SA, Lynch MR, Sargent PH et al (1992) The effect of intrauterine growth retardation on the development of renal nephrons. Br J Obstet Gynaecol 99:296–301. doi:10.1111/j.1471-0528.1992.tb13726.x

    PubMed  CAS  Google Scholar 

  16. Huxley RR, Shiell AW, Law CM (2000) The role of size at birth and postnatal catch-up growth in determining systolic blood pressure: a systematic review of the literature. J Hypertens 18:815–831. doi:10.1097/00004872-200018070-00002

    Article  PubMed  CAS  Google Scholar 

  17. Johansson S, Norman M, Legnevall L et al (2007) Increased catecholamines and heart rate in children with low birth weight: perinatal contributions to sympathoadrenal overactivity. J Intern Med 261:480–487. doi:10.1111/j.1365-2796.2007.01776.x

    Article  PubMed  CAS  Google Scholar 

  18. Law CM, Shiell AW (1996) Is blood pressure inversely related to birth weight? The strength of evidence from a systematic review of the literature. J Hypertens 14:935–941. doi:10.1097/00004872-199608000-00002

    Article  PubMed  CAS  Google Scholar 

  19. Law CM, Egger P, Dada O et al (2001) Body size at birth and blood pressure among children in develo** countries. Int J Epidemiol 30:52–57. doi:10.1093/ije/30.1.52

    Article  PubMed  CAS  Google Scholar 

  20. Law CM, Shiell AW, Newsome CA et al (2002) Fetal, infant, and childhood growth and adult blood pressure: a longitudinal study from birth to 22 years of age. Circulation 105:1088–1092. doi:10.1161/hc0902.104677

    Article  PubMed  CAS  Google Scholar 

  21. Leeson CP, Whincup PH, Cook DG et al (1997) Flow-mediated dilation in 9- to 11-year-old children: the influence of intrauterine and childhood factors. Circulation 96:2233–2238

    PubMed  CAS  Google Scholar 

  22. Levitt NS, Steyn K, de Wet T et al (1999) An inverse relation between blood pressure and birth weight among 5 year old children from Soweto, South Africa. J Epidemiol Community Health 53:264–268

    Article  PubMed  CAS  Google Scholar 

  23. Martin H, Hu J, Gennser G et al (2000) Impaired endothelial function and increased carotid stiffness in 9-year-old children with low birthweight. Circulation 102:2739–2744

    PubMed  CAS  Google Scholar 

  24. Martyn CN, Gale CR, Jespersen S et al (1998) Impaired fetal growth and atherosclerosis of carotid and peripheral arteries. Lancet 352:173–178. doi:10.1016/S0140-6736(97)10404-4

    Article  PubMed  CAS  Google Scholar 

  25. National High Blood Pressure Education Program Working Group on High Blood Pressure in Children and Adolescents (2004) The fourth report on the diagnosis, evaluation, and treatment of high blood pressure in children and adolescents. Pediatrics 114:555–576

    Article  Google Scholar 

  26. Primatesta P, Falaschetti E, Poulter NR (2005) Birth weight and blood pressure in childhood: results from the Health Survey for England. Hypertension 45:75–79

    PubMed  CAS  Google Scholar 

  27. Seidman DS, Laor A, Gale R et al (1991) Birth weight, current body weight, and blood pressure in late adolescence. BMJ 302:1235–1237

    PubMed  CAS  Google Scholar 

  28. Troy LM, Michels KB, Hunter DJ et al (1996) Self-reported birthweight and history of having been breastfed among younger women: an assessment of validity. Int J Epidemiol 25:122–127. doi:10.1093/ije/25.1.122

    Article  PubMed  CAS  Google Scholar 

  29. Walker SP, Gaskin P, Powell CA et al (2001) The effects of birth weight and postnatal linear growth retardation on blood pressure at age 11–12 years. J Epidemiol Community Health 55:394–398. doi:10.1136/jech.55.6.394

    Article  PubMed  CAS  Google Scholar 

  30. Widdowson EM, Crabb DE, Milner RD (1972) Cellular development of some human organs before birth. Arch Dis Child 47:652–655

    Article  PubMed  CAS  Google Scholar 

  31. Woelk G, Emanuel I, Weiss NS et al (1998) Birthweight and blood pressure among children in Harare, Zimbabwe. Arch Dis Child Fetal Neonatal Ed 79:F119–F122

    Article  PubMed  CAS  Google Scholar 

  32. Zandi-Nejad K, Luyckx VA, Brenner BM (2006) Adult hypertension and kidney disease: the role of fetal programming. Hypertension 47:502–508. doi:10.1161/01.HYP.0000198544.09909.1a

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Pediatrics, School of Medicine, Federal University of São Paulo, R. Botucatu, 598, São Paulo, SP, 04023-062, Brazil

    Maria Wany L. Strufaldi, Edina M. K. Silva & Rosana F. Puccini

  2. Division of Nephrology, School of Medicine, Federal University of São Paulo, São Paulo, Brazil

    Maria C. P. Franco

Authors
  1. Maria Wany L. Strufaldi
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  2. Edina M. K. Silva
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  3. Maria C. P. Franco
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  4. Rosana F. Puccini
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Correspondence to Rosana F. Puccini.

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Strufaldi, M.W.L., Silva, E.M.K., Franco, M.C.P. et al. Blood pressure levels in childhood: probing the relative importance of birth weight and current size. Eur J Pediatr 168, 619–624 (2009). https://doi.org/10.1007/s00431-008-0813-z

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  • DOI: https://doi.org/10.1007/s00431-008-0813-z

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