Abstract
Our objective was to compare the blood pressure of 20-y-old very low birth weight (VLBW; <1.5 kg) individuals with that of normal birth weight (NBW) control individuals. The population included 195 VLBW (92 female and 103 male) and 208 NBW (107 female and 101 male) individuals who were born between 1977 and 1979. Independent effects of birth weight status (VLBW versus NBW) and within the VLBW cohort of intrauterine growth (birth weight z score) were examined via multiple regression analyses. VLBW individuals had a higher mean systolic blood pressure (SBP) than NBW control individuals (114 ± 11 versus 112 ± 13 mm Hg). SBP for VLBW female infants was 110 ± 9 versus NBW 107 ± 12 and for VLBW male individuals was 118 ± 11 versus NBW 117 ± 11 mm Hg. After adjustment for gender, race, and maternal education, the difference in SBP between VLBW and NBW individuals was 1.9 mm Hg but was 3.5 mm after also adjustment for later size (20-y weight and height z scores), which reflects catch-up growth. For female individuals, the difference in SBP between VLBW and NBW individuals was significant both unadjusted and adjusted for later size, whereas for male individuals, the difference was significant only after adjustment for later size. Intrauterine growth did not have a significant effect on SBP within the VLBW group, even after adjustment for later size. VLBW individuals, specifically female individuals, have a higher SBP than NBW control individuals. This is not explained by intrauterine growth failure.
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Abbreviations
- BMI:
-
body mass index
- BP:
-
blood pressure
- DBP:
-
diastolic blood pressure
- NBW:
-
normal birth weight
- SBP:
-
systolic blood pressure
- SGA:
-
small for gestational age
- VLBW:
-
very low birth weight
References
Taylor HG, Klein N, Minich NM, Hack M 2000 Middle-school-age outcomes in children with very low birthweight. Child Dev 71: 1495–1511
Saigal S, den Ouden L, Wolke D, Hoult L, Paneth N, Streiner DL, Whitaker A, Pinto-Martin J 2003 School-age outcomes in children who were extremely low birth weight from four international population-based cohorts. Pediatrics 112: 943–950
Hack M, Breslau N, Aram D, Weissman B, Klein N, Borawski-Clark E 1992 The effect of very low birth weight and social risk on neurocognitive abilities at school age. J Dev Behav Pediatr 13: 412–420
Hack M, Flannery DJ, Schluchter M, Cartar L, Borawski E, Klein N 2002 Outcomes in young adulthood for very-low-birth-weight infants. N Engl J Med 346: 149–157
Cooke RW 2004 Health, lifestyle, and quality of life for young adults born very preterm. Arch Dis Child 89: 201–206
Hack M, Schluchter M, Cartar L, Rahman M, Cuttler L, Borawski E 2003 Growth of very low birthweight infants to age 20 years. Pediatrics 112: e30–e38. Available: www.pediatrics.org/cgi/content/full/112/1/e30
Doyle LW, Faber B, Callanan C, Morley R 2003 Blood pressure in late adolescence and very low birth weight. Pediatrics 111: 252–257
Pharoah POD, Stevenson CJ, West CR 1998 Association of blood pressure in adolescence with birthweight. Arch Dis Child Fetal Neonatal Ed 79: F114–F118
Dessens AB, Smolders-de Haas H, Koppe JG 2000 Twenty-year follow-up of antenatal corticosteroid treatment. Pediatrics 105: E77. Available: www.pediatrics.org/cgi/content/full/105/6/e77
Singhal A, Fewtrell M, Cole TJ, Lucas A 2003 Low nutrient intake and early growth for later insulin resistance in adolescents born preterm. Lancet 361: 1089–1097
Hack M, Youngstrom EA, Cartar L, Schluchter M, Taylor HG, Flannery D, Klein N, Borawski E 2004 Behavioral outcomes and evidence of psychopathology among very low birth weight infants at age 20 years. Pediatrics 114: 932–940
Forsen T, Eriksson JG, Tuomilehto J, Osmond C, Barker DJ 1999 Growth in utero and during childhood among women who develop coronary heart disease: longitudinal study. BMJ 319: 1403–1407
Fall CH, Osmond C, Barker DJ, Clark PM, Hales CN, Stirling Y, Meade TW 1995 Fetal and infant growth and cardiovascular risk factors in women. BMJ 310: 428–432
Klaus MH, Fanaroff AA 1979 Care of the High Risk Neonate. W.B. Saunders, Philadelphia
Hack M, Merkatz IR, Gordon D, Jones PK, Fanaroff AA 1982 The prognostic significance of postnatal growth in low-birth weight infants. Am J Obstet Gynecol 143: 693–699
Perloff D, Grim C, Flack J, Frohlich ED, Hill M, McDonald M, Morgenstern BZ 1993 Human blood pressure determination by sphygmomanometry. Circulation 88: 2460–2470
1995 Physical status: the use and interpretation of anthropometry: a report of a WHO expert committee. WHO Tech Rep Ser 854: 1–452
Freeman JV, Cole TJ, Chinn S, Jones PR, White EM, Preece MA 1995 Cross sectional stature and weight reference curves for the UK, 1990. Arch Dis Child 73: 17–24
Hardy R, Wadsworth M, Kuh D 2000 The influence of childhood weight and socioeconomic status on change in adult body mass index in a British national birth cohort. Int J Obes Relat Metab Disord 24: 725–734
Usher R, McLean F 1969 Intrauterine growth of live-born Caucasian infants at sea level: standards obtained from measurements in 7 dimensions of infants born between 25 and 44 weeks of gestation. J Pediatr 74: 901–910
Kuczmarski RJ, Ogden CL, Grummer-Strawn LM, Flegal KM, Guo SS, Wei R, Mei Z, Curtain LR, Roche AF, Johnson CL 2000 CDC growth charts: United States. Adv Data 8: 1–27
Cotten M, Oh W, McDonald S, Fanaroff AA, Duara S, Laptook A, Carlo WA, Stoll BJ, Poole K, Wright LL, Goldberg RN 2002 Predictors of prolonged hospital stay (PHS) for extremely low birth weight (ELBW) infants. [abstract]. Pediatr Res 51: 375A
Ross G, Krauss AN, Auld PA 1983 Growth achievement in low-birth-weight premature infants: relationship to neurobehavioral outcome at one year. J Pediatr 103: 105–108
Lucas A, Fewtrell MS, Cole TJ 1999 Fetal origins of adult disease-the hypothesis revisited. BMJ 319: 245–249
Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL, Jones DW, Materson BJ, Oparil S, Wright JT, Roccella EJ Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure 2003 Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. National Heart, Lung, and Blood Institute; National High Blood Pressure Education Program Coordinating Committee. Hypertension 42: 1206–1252
Light KC, Girdler SS, Sherwood A, Bragdon EE, Brownley KA, West SG, Hinderliter AL 1999 High stress responsivity predicts later blood pressure only in combination with positive family history and high life stress. Hypertension 33: 1458–1464
Blane D, Hart CL, Smith GD, Gillis CR, Hole DJ, Hawthorne VM 1996 Association of cardiovascular disease risk factors with socioeconomic position during childhood and during adulthood. BMJ 313: 1434–1438
Booth I 2001 Does the duration of breast feeding matter?. BMJ 322: 625–626
Alexander GR, Himes JH, Kaufman RB, Mor J, Kogan M 1996 A United States National Reference for fetal growth. Obstet Gynecol 87: 163–168
Kramer MS, Platt RW, Wen SW, Joseph KS, Allen A, Abrahamowicz M, Blondel B, Breart G ; Fetal/Infant Health Study Group of the Canadian Perinatal Surveillance System 2001 A new and improved population-based Canadian reference for birth weight for gestational age. Pediatrics 108: E35. Available: www.pediatric.org/cig/content/full/108/2/e35
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
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
Barker DJP 1998 Mothers, Babies and Health in Later Life. Churchill, Livingston, Edinburgh
Paneth N, Susser M 1995 Early origin of coronary heart disease (the “Barker hypothesis”). BMJ 310: 411–412
Leon DA 1998 Fetal growth and adult disease. Eur J Clin Nutr 52( suppl 1): S72–S82
Kramer MS 2000 Invited commentary: association between restricted fetal growth and adult chronic disease: is it causal? Is it important?. Am J Epidemiol 152: 605–608
Huxley R, Neil A, Collins R 2002 Unraveling the fetal origins hypothesis: is there really an inverse association between birthweight and subsequent blood pressure?. Lancet 360: 659–665
Schluchter MD 2003 Publication bias and heterogeneity in the relationship between systolic blood pressure, birth weight, and catch-up growth—a meta analysis. J Hypertens 21: 1–7
Stevenson CJ, West CR, Pharoah PO 2001 Dermatoglyphic patterns, very low birth weight, and blood pressure in adolescence. Arch Dis Child Fetal Neonatal Ed 84: F18–F22
Irving RJ, Belton NR, Elton RA, Walker BR 2000 Adult cardiovascular risk factors in premature babies. Lancet 355: 2135–2136
Kistner A, Celsi G, Vanpee M, Jacobson SH 2000 Increased blood pressure but normal renal function in adult women born preterm. Pediatr Nephrol 15: 215–220
Singhal A, Cole TJ, Lucas A 2001 Early nutrition in preterm infants and later blood pressure: two cohorts after randomized trials. Lancet 357: 413–419
Morley R, Lister G, Leeson-Payne C, Lucas A 1994 Size at birth and later blood pressure. Arch Dis Child 70: 536–537
Lucas A, Morley R 1994 Does early nutrition in infants born before term programme later blood pressure?. BMJ 309: 304–308
Doyle LW, Ford GW, Davis NM, Callanan C 2000 Antenatal corticosteroid therapy and blood pressure at 14 years of age in preterm children. Clin Sci (Lond) 98: 137–142
Gerber LM, Stern PM 1999 Relationship of body size and body mass to blood pressure: sex-specific and developmental influences. Hum Biol 71: 505–528
Bergel E, Haelterman E, Belizan J, Villar J, Carroli G 2000 Perinatal factors associated with blood pressure during childhood. Am J Epidemiol 151: 594–601
Roseboom TJ, van der Meulen JH, van Montfrans GA, Ravelli AC, Osmond C, Barker DJ, Bleker OP 2001 Maternal nutrition during gestation and blood pressure in later life. J Hypertens 19: 29–34
Campbell DM, Hall MH, Barker DJP, Cross J, Shiell AW, Godfrey KM 1996 Diet in pregnancy and the offspring's blood pressure 40 years later. Br J Obstet Gynaecol 103: 273–280
Churchill D, Perry IJ, Beevers DG 1997 Ambulatory blood pressure in pregnancy and fetal growth. Lancet 349: 7–10
Geleijnse JM, Hofman A, Witteman JC, Hazebroek AA, Valkenburg HA, Grobbee DE 1996 Long-term effects of neonatal sodium restriction on blood pressure. Hypertension 29: 913–917
Martin RM, McCarthy A, Smith GD, Davies DP, Ben-Shlomo Y 2003 Infant nutrition and blood pressure in early adulthood: the Barry Caerphilly Growth study. Am J Clin Nutr 77: 1489–1497
Martin RM, Ness AR, Gunnell D, Emmett P, Davey Smith G, ALSPAC Study Team 2004 Does breast-feeding in infancy lower blood pressure in childhood? The Avon Longitudinal Study of Parent and Children (ALSPAC). Circulation 109: 1259–1266
Forsyth JS, Willatts P, Agostoni C, Bissenden J, Casaer P, Boehm G 2003 Long chain polyunsaturated fatty acid supplementation in infant formula and blood pressure in later childhood: follow up of a randomized controlled trial. BMJ 326: 953–958
Owen CG, Whincup PH, Gilg JA, Cook DG 2003 Effect of breast feeding in infancy on blood pressure in later life: systematic review and meta-analysis. BMJ 327: 1189–1192
Falkner B, Hulman S, Kushner H 1998 Birth weight versus childhood growth as determinants of adult blood pressure. Hypertension 31: 145–150
Katz SH, Hediger ML, Schall JI, Bowers EJ, Barker WF, Aurand S, Eveleth PB, Gruskin AB, Parks JS 1980 Blood pressure, growth and maturation from childhood through adolescence. Mixed longitudinal analysis of the Philadelphia Blood Pressure Project. Hypertension 2: 55–69
Lucas A, Morley R, Hudson GJ, Bamford MF, Boon A, Crowle P, Dossetor JF, Pearse R 1988 Early sodium intake and later blood pressure in preterm infants. Arch Dis Child 63: 656–657
Morley R, Leeson C, Payne C, Lister G, Lucas A 1995 Maternal smoking and blood pressure in 7.5 to 8 year old offspring. Arch Dis Child 72: 120–124
Brenner BM, Garcia DL, Anderson S 1988 Glomeruli and blood pressure. Less of one, more the other?. Am J Hypertens 1: 335–347
Hinchliffe SA, Sargent PH, Howard CV, Chan YF, van Velszen D 1991 Human intrauterine renal growth expressed in absolute number of glomeruli assessed by the disector method and Cavalieri principle. Lab Invest 64: 777–784
Ingelfinger JR 2003 Is microanatomy destiny?. N Engl J Med 348: 99–100
Hostetter TH, Olson JL, Rennke HG, Venkatachalam MA, Brenner BM 2001 Hyperfiltration in remnant nephrons: a potentially adverse response to renal ablation. J Am Soc Nephrol 12: 1315–1325
Kistner A, Jacobson L, Jacobson SH, Svensson E, Hellstrom A 2002 Low gestational age associated with abnormal retinal vascularization and increased blood pressure in adult women. Pediatr Res 51: 675–680
Hellström A, Hard AL, Niklasson A, Svensson E, Jacobsson B 1998 Abnormal retinal vascularization in preterm children as a general vascular phenomenon. Lancet 352: 1827
Martyn CN, Greenwald SE 1997 Impaired synthesis of elastin in walls of aorta and large conduit arteries during early development as an initiating event in pathogenesis of systemic hypertension. Lancet 350: 953–955
Taylor SJ, Whincup PH, Cook DG, Papacosta O, Walker M 1997 Size at birth and blood pressure: cross sectional study in 8–11 year old children. BMJ 314: 475–480
Murray LJ, Gallagher AM, Boreham CA, Savage M, Smith GD 2001 Sex specific difference in the relation between birth weight and arterial compliance in young adults: The Young Hearts Project. J Epidemiol Community Health 55: 665–666
Akahoshi M, Soda M, Carter RL, Nakashima E, Shimaoka K, Seto S, Yano K 1996 Correlation between systolic blood pressure and physical development in adolescence. Am J Epidemiol 144: 51–58
Lauer RM, Clarke WR 1984 Childhood risk factors for high adult blood pressure: the Muscatine Study. Pediatrics 84: 633–641
Horta BL, Barros FC, Victora CG, Cole TJ 2003 Early and late growth and blood pressure in adolescence. J Epidemiol Community Health 57: 226–230
Williams S, Poulton R 2002 Birth size, growth, and blood pressure between the ages of 7 and 26 years: failure to support the fetal origins hypothesis. Am J Epidemiol 155: 849–852
Walker SP, Gaskin P, Powell CA, Bennett FI, Forrester TE, Grantham-McGregor S 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
Vasan RS, Larson MG, Leip EP, Kannel WB, Levy D 2001 Assessment of frequency of progression to hypertension in nonhypertensive participants in the Framingham Heart Study: a cohort study. Lancet 358: 1682–1686
Miura K, Daviglus ML, Dyer AR, Liu K, Garside DB, Stamler J, Greenland P 2001 Relationship of blood pressure to 25-year mortality due to coronary heart disease, cardiovascular diseases, and all causes in young adult men: the Chicago Heart Association Detection Project in Industry. Arch Intern Med 161: 1501–1508
Stamler J, Stamler R, Neaton JD 1993 Blood pressure, systolic and diastolic, and cardiovascular risks. US population data. Arch Intern Med 153: 598–615
Acknowledgements
We thank Blanche Caron, Debra Hoffman, Susan McGrath, Miriam Curran, Elizabeth Carter, and Terry Reid for assistance in compiling and analyzing the data and Alpher Torres for technical assistance.
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Supported by grants from the National Institutes of Health (RO1 HD34177 and M01 RR00080, General Clinical Research Center) and in part by a grant (96-46) from the Genentech Foundation for Growth and Development.
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Hack, M., Schluchter, M., Cartar, L. et al. Blood Pressure Among Very Low Birth Weight (<1.5 kg) Young Adults. Pediatr Res 58, 677–684 (2005). https://doi.org/10.1203/01.PDR.0000180551.93470.56
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DOI: https://doi.org/10.1203/01.PDR.0000180551.93470.56
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