Ambulatory blood pressure monitoring and renal functions in term small-for-gestational age children

Abstract

The aim of this study was to investigate the relationship between birth weight and blood pressure (BP) by means of ambulatory BP monitoring (ABPM) and renal functions in non-obese children who were born small-for-gestational age (SGA) at term. The study group consisted of 39 (19 female, 20 male; mean age 8.8 ± 2.6 years) children born SGA. Their data were compared to those of 27 (13 female, 14 male; mean age 8.2 ± 2.9 years) children born appropriate-for-gestational age (AGA). No difference between SGA and AGA children was observed based on office BP measurements and daytime, nighttime and 24-h ABPM. Seventeen SGA (48.6%) and nine AGA (37.5%) children had a 24-h systolic BP (SBP) load over 25%, and seven of these (5 SGA, 2 AGA) were hypertensive according to mean SBP values. The prevalence of the non-dipping phenomenon in SGA and AGA children was similar. Renal functions were normal and similar in both groups. Three children (2 SGA, 1 AGA) with normal glomerular filtration rate had higher microalbumin excretion and one SGA child had systolic hypertension according to the office BP. Our findings demonstrate that the influence of intrauterine growth restriction on BP is not manifested during the childhood period, and they do not support the existence of a negative relationship between birth weight and BP in children.

Update: Ambulatory Blood Pressure Monitoring in Children and Adolescents

“…82,83 Birth weight has been shown to be associated with ambulatory BP. Most but not all studies 84 find an inverse association between birth weight and daytime SBP after controlling for covariates. 85–89 Ethnicity is known to influence ambulatory BP in children and youths, an effect that may be attributable to racial differences in the relationship of body size to BP 90,91 or racial differences in the effect of psychosocial stress on BP.…”

Intra-uterine growth restriction as a risk factor for hypertension in children six to 10 years old : cardiovascular topic

“…The only research available to us that evaluated the association between birth weight and blood pressure assessment using ABPM measurements was in a group of 39 children with IUGR 6. However, the conclusions of Bilge et al differed from ours despite similar methods and a similar age of the study group, although fewer children were included in the study.…”

“…This is due to the fact that the developing foetus adapts to the undernutrition and insufficient amounts of oxygen through ‘metabolic programming’ and adaptation of the structure and function of certain organs (e.g. compensatory hypertrophy of the nephrons) 6,7…”

The independent associations of HbA1c, C-reactive protein and birth weight with cardiovascular disease, diabetes mellitus and chronic kidney disease in a remote Indigenous Australian community: a prospective cohort study

“…Several studies [215][216][217][218][219][220] suggest there is an increase in blood pressure as birth weight decreases, but there are recent studies suggesting there is either a positive or no association [221][222][223][224][225][226][227]. Several meta-analyses and systematic literature reviews have attempted to explain these differences and the three primary trends appear to be due to differences in populations, differences of analysis classifications and differences in adjusting for confounding variables [210,228,229].…”

“…Many of the populations exhibiting a positive or no association had either a lower number of participants [222,226], conducted in younger children [221], or conducted in post-pubertal adolescents [227]. Post-pubertal populations or those close to puberty-age make it difficult for analysis and accurate adjustment, due to the inconsistent age and characteristics of puberty for each individual.…”