Is Blood Pressure Increased 19 Years After Intrauterine Growth Restriction and Preterm Birth? A Prospective Follow-up Study in the Netherlands

Keijzer-Veen, Mandy G.; Finken, Martijn J J; Nauta, Jeroen; Dekker, Friedo W.; Hille, E.T.M.; Frölich, Marijke; Wit, Jan M.; Heijden, A. J. van der

doi:10.1542/peds.2005-0309

Cited by 140 publications

(92 citation statements)

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“…This study reports an association between reduced gestation length and elevated 24-h systolic blood pressure in children, which supports several recent studies linking reduced gestational age to elevated blood pressure in adults [13][14][15][16][17][18][19] and children. [20][21][22] Furthermore, evidence is presented linking reduced gestation length with elevated pulse pressure in children, suggesting that early arterial stiffness may be involved in the causal pathway culminating in hypertension in adulthood.…”

Section: Discussionsupporting

confidence: 91%

“…Other studies support this observation, linking earlier gestation and/or preterm birth with higher blood pressure in adults. [14][15][16][17][18] In a large family-based study of gestational age, intrauterine growth and blood pressure, Lawlor et al 19 provide evidence for an inverse association of gestational age with systolic blood pressure at age 17-19 years in both siblings and nonsiblings. Gestation length has also been linked to raised blood pressure in children.…”

Section: Introductionmentioning

confidence: 99%

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The relationship between gestational age, systolic blood pressure and pulse pressure in children

2008

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This cross-sectional study investigates the relationship between gestational age and systolic blood pressure and pulse pressure in childhood. Blood pressure was measured in 483 schoolchildren, free from cardiovascular disease, aged between 6 and 16 years. Pulse pressure was estimated as the difference between the 24-h mean systolic and diastolic blood pressure values. Linear regression showed an inverse relationship between gestational age and mean 24-h systolic blood pressure (adjusted regression coefficient mm Hg per week gestation À0.631, 95% confidence interval (CI) À1.21 to À0.04, P ¼ 0.036). Further, linear regression showed a significant negative association between gestational age and log-transformed pulse pressure (adjusted antilog regression coefficient mm Hg per week of gestation À1.39, 95% CI À2.96 to À0.3, P ¼ 0.013), which after gender-specific analyses was found to be restricted to the girls in the study. The results of the present study suggest that low gestational age is associated with elevated systolic blood pressure and pulse pressure in childhood, the latter particularly in girls. This observation provides some support for the developmental origins of adult disease hypothesis-that adverse events in early life may have long-term consequences for cardiovascular health. However, as gestational age itself is unlikely to be the causal event in determining blood pressure control, further investigation is required, particularly with regard to the nutritional, physiological and molecular mechanisms that explain such epidemiological observations.

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Section: Discussionsupporting

confidence: 91%

Section: Introductionmentioning

confidence: 99%

The relationship between gestational age, systolic blood pressure and pulse pressure in children

2008

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“…Preterm birth may be a risk to adult health (1,2). Several groups describe higher blood pressure (3)(4)(5)(6)(7). Insulin resistance (8) and poorer reproductive health (9) have also been reported.…”

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confidence: 99%

Aberrant Adiposity and Ectopic Lipid Deposition Characterize the Adult Phenotype of the Preterm Infant

et al. 2011

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Our investigation addresses the hypothesis that disruption of third trimester development by preterm birth alters multiple biological pathways affecting metabolic health in adult life. We compared healthy adult volunteers aged 18 -27 y born at Յ33 wk gestation or at term. We used whole-body MRI, 1 H magnetic resonance spectroscopy (MRS) of liver and muscle, metabonomic profiling of blood and urine, and anthropometric and blood pressure measurements. Preterm subjects had greater (mean difference (95% CI)) total [2.21 L (0.3, 4.1), p ϭ 0.03] and abdominal adipose tissue [internal 0.51 (0.1, 0.9), p ϭ 0.007]; blood pressure [systolic 6.5 mm Hg (2.2, 10.8), p ϭ 0.004; diastolic 5.9 (1.8, 10.1), p ϭ 0.006]; and ectopic lipid (ratio (95% CI)), intrahepatocellular lipid (IHCL) 3.01 (1.78, 5.28) p Ͻ 0.001, and tibialis-intramyocellular lipid (T-IMCL) [1.31 (1.02, 1.69) p ϭ 0.04]. In preterm, compared with term men, there was greater internal adipose tissue [mean (SD); men: preterm 4.0 (1.6), term 2.7 (1.1) liters; women: preterm 2.6 (0.9); term 2.6 (0.5); gender-gestation interaction p ϭ 0.048] and significant differences in the urinary metabolome (elevated methylamines and acetylglycoproteins, lower hippurate). We have identified multiple premorbid biomarkers in ex-preterm young adults, which are most marked in men and indicative of risks to later wellbeing. These data offer insight into biological trajectories affected by preterm birth and/or neonatal care. A round 2% of births in the developed world are below 33 wk gestation. This rate is rising as is survival and Ͼ90% of these infants will go home. Survival free of major impairment is also rising, bringing with it the expectation of life-long health. Preterm birth may be a risk to adult health (1,2). Several groups describe higher blood pressure (3-7). Insulin resistance (8) and poorer reproductive health (9) have also been reported. The biological mediators are unknown.We have previously shown that by term, preterm infants have an altered body composition with significantly greater abdominal adipose tissue (10) and intrahepatocellular lipid (IHCL) (11). There is a high degree of correlation between hypertension, insulin resistance, and abdominal obesity. Abdominal adipose tissue in particular seems to play a major role in the pathogenesis of the metabolic syndrome (12). Increased "ectopic" lipid in liver and muscle as IHCL and soleus and tibialis intramyocellular lipid (S-IMCL and T-IMCL) are also strongly associated with these conditions (13).In this proof-of-concept study, we postulated that disruption of the normal pattern of third trimester development by preterm birth will affect a range of systems affecting metabolic health. We tested the primary hypothesis that young adults born at or below 33 wk gestation would have increased abdominal adiposity in the absence of overt obesity. We also evaluated IHCL, IMCL, fasting glucose and insulin, insulin resistance, serum lipids and serum, and urine metabolomes. METHODSApproval for the study was obtained fro...

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“…This issue is of particular importance in light of recent studies showing that low birth weight and premature birth may predispose individuals to arterial hypertension and renal function alteration as young adults (9,14,15). Whereas nephrogenesis occurs until 8 -10 days postnatal in rats, it is achieved at ϳ34 -36 wk of gestation in humans.…”

mentioning

confidence: 99%

Effects of early postnatal hypernutrition on nephron number and long-term renal function and structure in rats

Boubred¹,

Buffat²,

Feuerstein³

et al. 2007

American Journal of Physiology-Renal Physiology

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September 26, 2007; doi:10.1152/ajprenal.00141.2007.-Various antenatal events impair nephrogenesis in humans as well as in several animal models. The consecutive low nephron endowment may contribute to an increased risk for cardiovascular and renal diseases in adulthood. However, little knowledge is available on the influence of the postnatal environment, especially nutrition, on nephrogenesis. Moreover, the consequences of early postnatal nutrition in late adulthood are not clear. We used a model of early postnatal overfeeding (OF) induced by reduction of litter size (3 pups/litter) in rats. Systolic blood pressure (SBP; plethysmography), glomerular filtration rate (clearance of creatinine), glomerular number and volume, and glomerulosclerosis were evaluated in 22-mo-old aging offspring. Early postnatal OF was associated with increased weight gain during the suckling period (ϩ40%, P Ͻ 0.01) and a 20% increase in glomerular number (P Ͻ 0.05). However, an increase in SBP at 12 mo by an average of 18 mmHg and an increase in proteinuria (2.6-fold) and glomerulosclerosis at 22 mo of age were observed in OF male offspring compared with controls. In conclusion, early postnatal OF in the rat enhances postnatal nephrogenesis, but elevated blood pressure and glomerulosclerosis are still observed in male adults. Factors other than glomerular number reduction are likely to contribute to the arterial hypertension induced by early postnatal OF. nephrogenesis; glomerular number; overfeeding; arterial blood pressure; infant; newborn; developmental origins of adult diseases

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Is Blood Pressure Increased 19 Years After Intrauterine Growth Restriction and Preterm Birth? A Prospective Follow-up Study in the Netherlands

Abstract: The prevalence of hypertension is high in individuals who were born preterm when compared with the general population. In the individuals who were born very preterm, no support to the hypothesis that low birth weight is associated with increased BP at young adult age can be given.

Cited by 140 publications

References 39 publications

The relationship between gestational age, systolic blood pressure and pulse pressure in children

The relationship between gestational age, systolic blood pressure and pulse pressure in children

Aberrant Adiposity and Ectopic Lipid Deposition Characterize the Adult Phenotype of the Preterm Infant

Effects of early postnatal hypernutrition on nephron number and long-term renal function and structure in rats

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