Effect of Birth Weight on Blood Pressure and Body Size in Early Adolescence

Abstract

Abstract-The fetal programming theory that birth weight contributes to blood pressure or body size in later life is examined in this study. A prospective longitudinal study was conducted on subjects who were examined as newborns and prospectively interviewed and re-examined at 11 to 14 years old. Low birth weight (Ͻ2500 g) was present in 36% of the sample. The adolescent examination included measurements of blood pressure (BP), both auscultation and oscillometric methods; anthropometrics (height, weight, and body mass index [BMI]); health status; and health behaviors. Data were analyzed on 250 subjects. Correlation coefficients of birth weight with all BP measures were nonsignificant, except for the last auscultated diastolic BP (rϭ0.19, PϽ0.01), which had a positive relationship. The simple correlation coefficients of birth weight with adolescent body size were significant and positive for weight and BMI. After multiple linear regression analyses with adjustments for age, Tanner stage, and gestational age, there was no significant effect of birth weight on adolescent weight or BMI. No significant correlations were detected for ponderal index at birth with adolescent measures. This study, which includes a substantial portion of low-birth-weight cases (36%), indicates that birth weight does not correlate negatively with later BP. These results do not support the low-birth-weight theory and indicate that childhood factors that are more proximal have a greater effect on adolescent BP than intrauterine factors. Key Words: blood pressure Ⅲ adolescence C ardiovascular diseases are the leading causes of morbidity and mortality in the United States. These disorders emerge from an interplay of genetic and environmental factors and appear to be rooted in childhood. A number of publications have reported data supporting an additional causal theory, in which an interaction of the intrauterine nutritional environment with fetal growth also contributes to expression of cardiovascular disease in later life. According to this theory, an impaired intrauterine environment that deprives the fetus of optimal nutrient delivery programs the fetus to express, in later life, ischemic heart disease, type 2 diabetes mellitus, hypertension, and stroke. 1-3 Suboptimal intrauterine nutrition would restrict fetal growth and result in lower birth weight. Thus, low birth weight has become the clinical marker of a suboptimal intrauterine environment and a possible risk factor for future chronic disease.Despite the appeal of this novel hypothesis, it still lacks complete scientific evidence in humans. There is a substantial body of retrospective data from the Barker group 4 and elegant experimental investigations in animals 5 that support the fetal programing theory. However, data from epidemiological and clinical investigations have not consistently supported the theory. A significant inverse relationship between birth weight and blood pressure (BP) has been reported from several studies. 6 -8 In children, some investigators have detected a de...

Obesidade: principal fator de risco para hipertensão arterial sistêmica em adolescentes brasileiros participantes de um estudo de coorte

“…Assim como o verificado no presente estudo, outras investigações não observaram associação inversa entre HAS e peso ao nascer (8,32), corroborando a hipótese de que a ação de fatores pós-natais exerce maior efeito sobre a PA do que os intrauterinos (32,33).…”

Higher exercise frequency associated with lower blood pressure in Hong Kong adolescents: a population-based study

“…Some studies try to overcome this problem using mechanical monitors for physical activity assessment and for further demonstration of the dose-response effect. [28][29][30] However, the problem facing development of rigorous techniques for measuring physical activity is the lack of an ideal standard with which to validate the data, thus making it difficult to truly validate any given technique. Therefore, most of the physical activity studies have been based on questionnaires that have the ability to gather activity information in a short time at low cost.…”

Birth weight, puberty, and systolic blood pressure in children and adolescents: a longitudinal analysis

“…However, our results were in agreement with that of previous studies, which reported nonsignificant relations of birth weight to SBP among black children and adolescents. 3,6,7 Furthermore, the longitudinal design of our study with upto six repeated measures for SBP could improve power for detecting the differences in SBP among birth weight categories or pubertal stages. 39 Despite these limitations, the present study for the first time examined the role of puberty as a potential effect modifier in the association between birth weight and SBP in children.…”

“…3 However, findings of the association between birth weight and SBP during adolescence have been inconsistent. 3 Previous studies have reported inverse, [3][4][5] nonsignificant, 3,6,7 or positive 3,8 associations between birth weight and SBP in early and late adolescence.…”