Abstract
AIMS—To compare the blood pressure of very low birthweight infants with that of normal birthweight controls in adolescence. METHODS—A cohort of all infants of birthweight ⩽ 1500 g born to women resident in the county of Merseyside in 1980-1 was followed up at age 15 years with age, sex, and school matched controls. Growth indices and blood pressures were measured under standard conditions. The smoking history of mothers and children and their status for several socioeconomic variables were documented. In a matched pairs analysis systolic and diastolic blood pressures were compared for cases and controls before and after adjusting for height, weight, and body mass index. RESULTS—There were 172 singleton 15 year old survivors of birthweight <1500 g out of 40 321 live births to Merseyside residents in 1980-1. Of the 172 survivors, 128 (74%) who had no clinical disability and 11 (6%) with a clinical disability but attending normal schools, were assessed with individually matched age, sex, and school controls. Twenty three (13%) had a clinical disability and were attending special schools; these were assessed without controls. Ten (6%) children refused or were unavailable for assessment. The systolic blood pressure was significantly higher in cases than in controls; the mean of the difference was 3.2 mm Hg. The diastolic blood pressure was also higher in the cases, but the difference was not significant. The controls were significantly heavier (4.4kg), taller (4.0 cm), with larger head circumference (1.5 cm) than the cases. The difference in body mass index was not significant. Adjusting for height, weight, or body mass index increased the difference in systolic blood pressure between cases and controls. There were no significant differences in the socioeconomic variables, but what differences did exist favoured the controls. There was also a higher prevalence of smoking among the children and the mothers of the cases than the controls. CONCLUSIONS—The study supports the hypothesis that in adolescents variation in systolic blood pressure has its origins in fetal development. Some of the variation could be attributed to socioeconomic differences.
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- Barker D. J., Bull A. R., Osmond C., Simmonds S. J. Fetal and placental size and risk of hypertension in adult life. BMJ. 1990 Aug 4;301(6746):259–262. doi: 10.1136/bmj.301.6746.259. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Barker D. J., Osmond C., Golding J., Kuh D., Wadsworth M. E. Growth in utero, blood pressure in childhood and adult life, and mortality from cardiovascular disease. BMJ. 1989 Mar 4;298(6673):564–567. doi: 10.1136/bmj.298.6673.564. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Barker D. J., Osmond C. Infant mortality, childhood nutrition, and ischaemic heart disease in England and Wales. Lancet. 1986 May 10;1(8489):1077–1081. doi: 10.1016/s0140-6736(86)91340-1. [DOI] [PubMed] [Google Scholar]
- Barker D. J., Osmond C., Law C. M. The intrauterine and early postnatal origins of cardiovascular disease and chronic bronchitis. J Epidemiol Community Health. 1989 Sep;43(3):237–240. doi: 10.1136/jech.43.3.237. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Donker G. A., Labarthe D. R., Harrist R. B., Selwyn B. J., Wattigney W., Berenson G. S. Low birth weight and blood pressure at age 7-11 years in a biracial sample. Am J Epidemiol. 1997 Mar 1;145(5):387–397. doi: 10.1093/oxfordjournals.aje.a009120. [DOI] [PubMed] [Google Scholar]
- Gennser G., Rymark P., Isberg P. E. Low birth weight and risk of high blood pressure in adulthood. Br Med J (Clin Res Ed) 1988 May 28;296(6635):1498–1500. doi: 10.1136/bmj.296.6635.1498. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Greenland S., Robins J. Invited commentary: ecologic studies--biases, misconceptions, and counterexamples. Am J Epidemiol. 1994 Apr 15;139(8):747–760. doi: 10.1093/oxfordjournals.aje.a117069. [DOI] [PubMed] [Google Scholar]
- Hales C. N., Barker D. J., Clark P. M., Cox L. J., Fall C., Osmond C., Winter P. D. Fetal and infant growth and impaired glucose tolerance at age 64. BMJ. 1991 Oct 26;303(6809):1019–1022. doi: 10.1136/bmj.303.6809.1019. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Holland F. J., Stark O., Ades A. E., Peckham C. S. Birth weight and body mass index in childhood, adolescence, and adulthood as predictors of blood pressure at age 36. J Epidemiol Community Health. 1993 Dec;47(6):432–435. doi: 10.1136/jech.47.6.432. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Laor A., Stevenson D. K., Shemer J., Gale R., Seidman D. S. Size at birth, maternal nutritional status in pregnancy, and blood pressure at age 17: population based analysis. BMJ. 1997 Aug 23;315(7106):449–453. doi: 10.1136/bmj.315.7106.449. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Law C. M., Barker D. J., Bull A. R., Osmond C. Maternal and fetal influences on blood pressure. Arch Dis Child. 1991 Nov;66(11):1291–1295. doi: 10.1136/adc.66.11.1291. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Law C. M., Shiell A. W. Is blood pressure inversely related to birth weight? The strength of evidence from a systematic review of the literature. J Hypertens. 1996 Aug;14(8):935–941. [PubMed] [Google Scholar]
- Law C. M., de Swiet M., Osmond C., Fayers P. M., Barker D. J., Cruddas A. M., Fall C. H. Initiation of hypertension in utero and its amplification throughout life. BMJ. 1993 Jan 2;306(6869):24–27. doi: 10.1136/bmj.306.6869.24. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Powell T. G., Pharoah P. O., Cooke R. W. Survival and morbidity in a geographically defined population of low birthweight infants. Lancet. 1986 Mar 8;1(8480):539–543. doi: 10.1016/s0140-6736(86)90893-7. [DOI] [PubMed] [Google Scholar]
- Rutan G. H., McDonald R. H., Kuller L. H. A historical perspective of elevated systolic vs diastolic blood pressure from an epidemiological and clinical trial viewpoint. J Clin Epidemiol. 1989;42(7):663–673. doi: 10.1016/0895-4356(89)90010-3. [DOI] [PubMed] [Google Scholar]
- Seidman D. S., Laor A., Gale R., Stevenson D. K., Mashiach S., Danon Y. L. Birth weight, current body weight, and blood pressure in late adolescence. BMJ. 1991 May 25;302(6787):1235–1237. doi: 10.1136/bmj.302.6787.1235. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Stamler J., Stamler R., Neaton J. D. Blood pressure, systolic and diastolic, and cardiovascular risks. US population data. Arch Intern Med. 1993 Mar 8;153(5):598–615. doi: 10.1001/archinte.153.5.598. [DOI] [PubMed] [Google Scholar]
- Taylor S. J., Whincup P. H., Cook D. G., Papacosta O., Walker M. Size at birth and blood pressure: cross sectional study in 8-11 year old children. BMJ. 1997 Feb 15;314(7079):475–480. doi: 10.1136/bmj.314.7079.475. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Whincup P. H., Cook D. G., Papacosta O. Do maternal and intrauterine factors influence blood pressure in childhood? Arch Dis Child. 1992 Dec;67(12):1423–1429. doi: 10.1136/adc.67.12.1423. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Whincup P. H., Cook D. G., Shaper A. G. Early influences on blood pressure: a study of children aged 5-7 years. BMJ. 1989 Sep 2;299(6699):587–591. doi: 10.1136/bmj.299.6699.587. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Whincup P. H., Cook D. G., Shaper A. G., Macfarlane D. J., Walker M. Blood pressure in British children: associations with adult blood pressure and cardiovascular mortality. Lancet. 1988 Oct 15;2(8616):890–893. doi: 10.1016/s0140-6736(88)92481-6. [DOI] [PubMed] [Google Scholar]
- Whincup P., Cook D., Papacosta O., Walker M. Birth weight and blood pressure: cross sectional and longitudinal relations in childhood. BMJ. 1995 Sep 23;311(7008):773–776. doi: 10.1136/bmj.311.7008.773. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Williams S., St George I. M., Silva P. A. Intrauterine growth retardation and blood pressure at age seven and eighteen. J Clin Epidemiol. 1992 Nov;45(11):1257–1263. doi: 10.1016/0895-4356(92)90167-l. [DOI] [PubMed] [Google Scholar]