Lower birth weight due to fetal growth restriction is associated with higher blood pressure later in life, but the extent to which preterm birth (<37 completed weeks’ gestation) or very low birth weight (<1500g) predicts higher blood pressure is less clear. We performed a systematic review of 27 observational studies that compared the resting or ambulatory systolic blood pressure, or diagnosis of hypertension, among children, adolescents, and adults born preterm or very low birth weight with those born full term. We performed a meta-analysis with the subset of 10 studies that reported the resting systolic blood pressure difference in mmHg with 95% confidence intervals or standard errors. We assessed methodological quality with a modified Newcastle-Ottawa scale. The 10 studies comprised 1342 preterm or very low birth weight and 1738 full term participants from 8 countries. The mean gestational age at birth of the preterm participants was 30.2 weeks (range, 28.8 to 34.1), birth weight 1280 grams (1098 to 1958), and age at systolic blood pressure measurement 17.8 years (6.3 to 22.4). Former preterm or very low birth weight infants had higher systolic blood pressure than full term infants (pooled estimate 2.5 mmHg, 95% CI: 1.7, 3.3). For the 5 highest quality studies, the systolic blood pressure difference was slightly greater, 3.8 mmHg (95% CI 2.6, 5.0). We conclude that infants who are born preterm or very low birth weight have modestly higher systolic blood pressure later in life, and may be at increased risk for developing hypertension and its sequelae.

We established Project Viva to examine prenatal diet and other factors in relation to maternal and child health. We recruited pregnant women at their initial prenatal visit in eastern Massachusetts between 1999 and 2002. Exclusion criteria included multiple gestation, inability to answer questions in English, gestational age ≥22 weeks at recruitment and plans to move away before delivery. We completed in-person visits with mothers during pregnancy in the late first (median 9.9 weeks of gestation) and second (median 27.9 weeks) trimesters. We saw mothers and children in the hospital during the delivery admission and during infancy (median age 6.3 months), early childhood (median 3.2 years) and mid-childhood (median 7.7 years). We collected information from mothers via interviews and questionnaires, performed anthropometric and neurodevelopmental assessments and collected biosamples. We have collected additional information from medical records and from mailed questionnaires sent annually to mothers between in-person visits and to children beginning at age 9 years. From 2341 eligible women, there were 2128 live births; 1279 mother-child pairs provided data at the mid-childhood visit. Primary study outcomes include pregnancy outcomes, maternal mental and cardiometabolic health and child neurodevelopment, asthma/atopy and obesity/cardiometabolic health. Investigators interested in learning more about how to obtain Project Viva data can contact Project_Viva@hphc.org.