366 Familial Aggregation of Blood Pressure in Newborn Infants

Lee, Yhu-Hsiung; Rosner, Bernard; Zinner, Stephen H.; Gould, Jeffrey B.; Lowe, Ernest W.; Kass, Edward H.

doi:10.1203/00006450-197804001-00371

Cited by 19 publications

(34 citation statements)

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“…Hence, the inverse relationship between blood pressure and birth weight that has been recognized in childhood and adulthood was not yet present at this time. Therefore, these results concord with other published data [17][18][19] that found a direct relationship between blood pressure and birth weight during the fi rst days of life. The present study has added to these, by showing that such a relationship may extend to the entire neonatal period, on the basis of the results from the 30 th day of life.…”

Section: Discussioncontrasting

confidence: 51%

Blood pressure and kidney size in term newborns with intrauterine growth restriction

Matsuoka¹,

Shibao²,

Leone³

2007

Sao Paulo Med. J.

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CONTEXT AND OBJECTIVE: Low birth weight is associated with higher blood pressure in childhood and adulthood. The aim of this study was to investigate the influence of intrauterine growth restriction (IUGR) on newborn systolic blood pressure (SBP). DESIGN AND SETTING: Prospective comparative study at Neonatal and Intensive in Clinical Pediatrics Division, Maternity Hospital in Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo. METHODS: 35 newborns with IUGR and 35 without IUGR were compared. Healthy term newborns without malformations, with Apgar score at fifth minute > 6 were included. Birth weight, kidney weight/birth weight ratio, kidney weight (ultrasound scan), plasma renin activity (PRA) and SBP evolution were analyzed during the first month of life (on 1st, 3rd, 7th and 30th days). RESULTS: SBP evolution, kidney weight/birth weight ratio and PRA did not differ between the two groups. In newborns with IUGR, SBP presented positive correlations with birth weight (r = 0.387 p = 0.026) and BMI (r = 0.412 p = 0.017) on the 7th day of life. Positive correlations with birth weight (r = 0.440 p = 0.01) and birth length (r = 0.386 p = 0.026) were also seen on the 30th day. There was an inverse correlation on the 7th day between SBP and kidney weight/birth weight ratio (r = -0.420 p = 0.014), but this did not persist to the end of the month. CONCLUSIONS: IUGR seems not to have any influence on SBP, PRA or kidney weight among term newborns during their first month of life.

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Section: Discussioncontrasting

confidence: 51%

Blood pressure and kidney size in term newborns with intrauterine growth restriction

Matsuoka¹,

Shibao²,

Leone³

2007

Sao Paulo Med. J.

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“…While the majority of epidemiologic studies (1, 2) have found inverse relationships between birth weight and arterial pressure in adults and children, some studies of infants have found positive relationships as in our study. Studies of human neonates have found that arterial pressure is positively correlated with birth weight up to 8 d after birth (21)(22)(23). It is possible that there is a "crossing-over" from relative hypotension to relative hypertension in individuals affected by IUGR some time after the early postnatal period.…”

Section: Discussionmentioning

confidence: 99%

Placental Insufficiency and Fetal Growth Restriction Lead to Postnatal Hypotension and Altered Postnatal Growth in Sheep

et al. 2000

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Low birth weight has been associated with elevated arterial pressure in later life but mechanisms are unknown. Our aim was to determine the effects of low birth weight resulting from intrauterine growth restriction (IUGR) on fetal and postnatal arterial pressures and the potential roles of circulating cortisol and renin. We induced IUGR by umbilico-placental embolization (UPE) in fetal sheep from 120 d of gestation until birth (approximately 147 d); postnatal lambs (8 IUGR, 8 controls) were studied for 8 wk. Fetal and postnatal arterial pressures were measured and blood samples taken for measurement of gas tensions, cortisol concentrations and renin activity. In IUGR fetuses, mean arterial pressure (MAP) initially increased with UPE, but near term was not different to values in controls. IUGR lambs weighed 33% less than controls at birth and remained lighter than controls during the 8 postnatal weeks; their growth pattern was different to that of controls. IUGR lambs had lower MAP than controls, and this relative hypotension (Ϫ4 mm Hg) persisted throughout the 8 postnatal weeks. Covariate analysis showed that the relative hypotension of IUGR lambs could have resulted from their smaller size. Plasma cortisol concentrations were not different between IUGR and control animals before or after birth. Plasma renin activity was not different in postnatal IUGR lambs compared with controls. Thus, postnatal cortisol and renin levels were not consistent with the development of hypotension or hypertension. We conclude that late gestational IUGR in sheep leads to relative hypotension in the early postnatal period, probably a result of reduced body size. There is increasing evidence that low birth weight resulting from intrauterine growth restriction (IUGR) is associated with an increased risk of later illness. Associations have been demonstrated between low birth weight and an increased risk of adult-onset diseases such as hypertension, coronary heart disease and type II diabetes (1, 2). In adults, an inverse relationship has been found between arterial pressure and birth weight (3, 4) and this relationship has been found to be independent of current body size and lifestyle factors (1). Studies in children have also revealed inverse relationships between birth weight and arterial pressure (5). The relationship in adolescents is less clear with some studies finding inverse relationships between birth weight and arterial pressure (6) and others finding positive relationships (7). Based on epidemiologic findings, it has been proposed that hypertension is initiated in utero and is amplified with age (8).Several studies of fetal growth restriction in animals have also shown relationships between a sub-optimal intrauterine environment and arterial pressure. Mid-gestational uterine artery ligation in guinea pigs has been shown to produce growth restricted offspring with an elevated mean arterial pressure (9). In the rat, a low protein diet during pregnancy also leads to growth restricted offspring with an elevated systolic pressure...

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“…Vários fatores podem influenciar os níveis de pressão arterial no RN: idade gestacional 1,10 e idade pós-natal 1,10-13 , peso de nascimento 1,[10][11][12]14,15 , choro 1,10,15 ou sucção 5,15 e a temperatura 5 . Em crianças maiores, a PA aumenta com o crescimento pôndero-estatural.…”

Section: Discussionunclassified

Evolution of systemic arterial blood pressure during neonatal period in term newborns adequate for gestacional age

Matsuoka

Pinheiro²,

Pascuas³

et al. 1996

J Pediatr (Rio J)

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IntroduçãoA pressão arterial sistêmica (PA) pode ser determinada através de diferentes métodos. As técnicas mais largamente utilizadas incluem registro direto da pressão intraarterial, uso do esfigmomanômetro e palpação, ultra-somdoppler e oscilometria 1 . Os registros diretos são obtidos no RN por meio de cateterização da aorta abdominal, através da artéria umbilical. Constitui a forma mais precisa de medida da PA, mas está associada a complicações como infecção, vasoespasmo e formação de trombos, além de dificultar a monitorização do paciente fora da UTI 1,2,3 . A oscilometria tem sido empregada como método de determinação da PA há muitos anos 4 . No início deste século, Balard já citava que a oscilometria era o único método que possibilitava a determinação da PA em crianças pequenas 4 . Atualmente, está comprovada a correlação entre a variação da PA determinada pela técnica de oscilometria e aquela obtida por cateter intra-arterial 1,4-7 . Sendo assim, a oscilometria constitui um instrumento de grande utilidade para a monitorização não-invasiva de pacientes graves e para determinação da PA no exame detalhado do RN.Não existe consenso na literatura quanto à definição de hipertensão arterial sistêmica no RN. De forma geral, considera-se hipertensão arterial a presença de pressão sistólica dois desvios-padrão acima do esperado para idade e peso de nascimento 1 . Entretanto, ainda existem poucos estudos com rigidez metodológica relativos à distribuição dos níveis de PA em RN normais, particularmente em nosso meio. ResumoOs autores estudaram a evolução dos níveis médios de pressão arterial sistêmica (PAS) sistólica, média e diastólica em RNT-AIG durante o primeiro mês de vida, utilizando a técnica de oscilometria, com monitor não invasivo de pressão arterial. Foi realizado um estudo prospectivo, em que foram acompanhados apenas RN com Apgar de 1º minuto > 7, sem intercorrências clínicas e sem uso de drogas com possíveis efeitos sobre a PA. Foram medidos os valores de PA sistólica, média e diastólica na 12ª hora de vida e no 3º, 7º, 14º e 28º dias de vida. Demonstraram que existe uma elevação dos níveis de PA no RN estatisticamente significante do 1º ao 3º dia e entre este e o 7º dia de vida. A partir da primeira semana de vida, até o final do 1º mês, essas modificações não foram significativas.J. pediatr. (Rio J.). 1996; 72(3):155-158: pressão arterial, recém-nascidos, oscilometria. AbstractThe authors studied the levels and evolution of systolic, mean and diastolic arterial blood pressure in term newborns adequate for gestacional age during the first month of life. The applied technique was oscillometric, using a non-invasive monitor. The study was prospective, including newborns who had received first minute Apgar score above 6, with no clinical disturbances or use of any drug with possible arterial blood pressure side effects. The measurements of systolic, mean and diastolic arterial blood pressure were taken at 12 hours of life and 3rd, 7th, 14th and 28th days of life. The authors observed an increase in arter...

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366 Familial Aggregation of Blood Pressure in Newborn Infants

Cited by 19 publications

References 0 publications

Blood pressure and kidney size in term newborns with intrauterine growth restriction

Blood pressure and kidney size in term newborns with intrauterine growth restriction

Placental Insufficiency and Fetal Growth Restriction Lead to Postnatal Hypotension and Altered Postnatal Growth in Sheep

Evolution of systemic arterial blood pressure during neonatal period in term newborns adequate for gestacional age

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