Association among prematurity (&lt;30 weeks’ gestational age), blood pressure, urinary albumin, calcium, and phosphate in early childhood

Vashishta, Namrata; Surapaneni, Vidya; Chawla, Sanjay; Kapur, Gaurav; Natarajan, Girija

doi:10.1007/s00467-017-3581-z

Cited by 18 publications

(24 citation statements)

References 28 publications

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“…Repeated high DBP in our study was associated with female sex, family history of hypertension, and preterm birth. Similar to our results, a case-control study with children under 5 years of age found that preterm children had higher systolic and diastolic BP than those born at term [39]. Additionally, results from previous studies investigating adult cardiometabolic risks have suggested a linear relationship between shorter gestation duration and higher BP in adults [40–42].…”

Section: Discussionsupporting

confidence: 90%

Repeated high blood pressure at 6 and 11 years at the Pelotas 2004 birth cohort study

et al. 2019

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Background We evaluated the prevalence and the factors associated with repeated high systolic (SBP) and diastolic blood pressure (DBP) at 6- and 11-year follow-ups of children from the Pelotas (Brazil) 2004 Birth Cohort. Methods All live births to mothers living in the urban area of Pelotas were enrolled in the cohort. Blood pressure (BP) values were transformed into Z-scores by sex, age, and height. High SBP and DBP were defined as repeated systolic and diastolic BP Z-scores on the ≥95th percentile at the two follow-ups. Prevalence (95% confidence interval) of repeated high SBP, DBP, and both (SDBP) were calculated. Associations with maternal and child characteristics were explored in crude and adjusted logistic regression analyses. Results A total of 3182 cohort participants were analyzed. Prevalence of repeated high SBP, DBP and SDBP was 1.7% (1.2–2.1%), 2.3% (1.8–2.9%) and 1.2% (0.9–1.6%), respectively. Repeated high SBP was associated with males, gestational diabetes mellitus (2.92; 1.13–7.58) and obesity at 11 years (2.44; 1.29–4.59); while repeated high DBP was associated with females, family history of hypertension from both sides (3.95; 1.59–9.85) and gestational age < 34 weeks (4.08; 1.52–10.96). Repeated high SDBP was not associated with any of the characteristics investigated. Conclusion Prevalence of repeated high SBP, DBP, and SDBP were within the expected distribution at the population level. Nonetheless, gestational diabetes mellitus, obesity, family history of hypertension, and prematurity increased the risk of repeated high blood pressure measured at two occasions 5 years apart.

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Section: Discussionsupporting

confidence: 90%

Repeated high blood pressure at 6 and 11 years at the Pelotas 2004 birth cohort study

et al. 2019

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“…Early elevated blood pressure in children born very preterm, and even hypertension, has been reported in previous studies [37, 38]. It is debatable whether office blood pressure measurements are capable of reflecting true elevation of blood pressure or if there is a risk for overestimation.…”

Section: Discussionmentioning

confidence: 96%

Kidney volume, kidney function, and ambulatory blood pressure in children born extremely preterm with and without nephrocalcinosis

et al. 2019

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BackgroundReduced kidney volume (KV) following prematurity is a proxy for reduced nephron number and is associated with the development of hypertension and end-stage renal disease in adults. We investigated whether extreme prematurity affects KV, function, and blood pressure in school-aged children and if nephrocalcinosis (NC) developed during the neonatal period had additional effects.MethodsWe investigated 60 children at a mean age of 7.7 years: 20 born extremely preterm (EPT < 28 weeks gestational age with NC (NC+)), 20 born EPT without NC (NC−), and 19 born as full-term infants (control). We measured KV by ultrasound, collected blood and urine samples to evaluate renal function, and measured office and 24-h ambulatory blood pressure (ABPM).ResultsChildren born EPT had significantly smaller kidneys (EPT (NC+ NC−) vs control (estimated difference, 11.8 (CI − 21.51 to − 2.09 ml), p = 0.018) and lower but normal cystatin C–based glomerular filtration rate compared with control (estimated difference, − 10.11 (CI − 0.69 to − 19.5), p = 0.035). KV and function were not different between NC+ and NC− groups. Change in KV in relation to BSA (KV/BSA) from the neonatal period to school age showed significantly more EPT children with neonatal NC having a negative evolution of KV (p = 0.01). Blood pressure was normal and not different between the 3 groups. Fifty percent of EPT had a less than 10% day-to-night decline in ABPM.ConclusionsKidney growth and volume is affected by EPT birth with NC being a potential aggravating factor. Circadian blood pressure regulation seems abnormal in EPT-born children.

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“…Our study revealed a novel effect of obesity on BP: the preterm-term difference in DBP was modestly greater among individuals with a BMI <85 th percentile compared to those with OWO, though this interaction approached statistical significance. Obesity generally increases the risk of hypertension in children and adolescents as well as adults, but there is a dearth of evidence about obesity’s role in the development of hypertension in preterm-born individuals [22, 30, 31]. A possible interpretation of our analysis is that prematurity may induce adverse cardiovascular changes akin to those ascribed to obesity alone.…”

Section: Discussionmentioning

confidence: 96%

“…The age at which preterm-term differences in BP are apparent is variable. Differences in BP have been described by 6 years of age [22]. While BP differences have been described in individuals into their 30’s, most studies do not consistently demonstrate when hypertension itself develops [23].…”

Section: Discussionmentioning

confidence: 99%

Renal function and blood pressure are altered in adolescents born preterm

et al. 2018

Pediatr Nephrol

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Association among prematurity (<30 weeks’ gestational age), blood pressure, urinary albumin, calcium, and phosphate in early childhood

Abstract: Even in early childhood, children born preterm had significantly elevated BP, compared with their term-born counterparts. Closer monitoring of BPs in this population may be warranted.

Cited by 18 publications

References 28 publications

Repeated high blood pressure at 6 and 11 years at the Pelotas 2004 birth cohort study

Repeated high blood pressure at 6 and 11 years at the Pelotas 2004 birth cohort study

Kidney volume, kidney function, and ambulatory blood pressure in children born extremely preterm with and without nephrocalcinosis

Renal function and blood pressure are altered in adolescents born preterm

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