Associations of Birth Weight and Postnatal Weight Gain With Cardiometabolic Risk Parameters at 5 Years of Age

Abstract

Abstract-The present prospective study assessed the impact of birth weight (BW) and postnatal weight gain on blood pressure and metabolic profile during the first 5 years of life. One hundred thirty-nine newborns (63 women) born at term after uncomplicated pregnancies and in the absence of perinatal illness were included. Subjects were divided according to size at birth in small, appropriate, and large for gestational age. After the initial evaluation on the second day of life, infants were followed up at 6 months and 2 and 5 years. Anthropometric parameters and blood pressure were measured at each visit and metabolic assessment was performed at 5 years of age. Among the BW groups, mothers did not differ in terms of age, smoking, and weight gain during pregnancy. BW was a positive determinant of systolic blood pressure at birth. Afterward, current weight was the strongest determinant, becoming significant at 2 years of age and progressively increasing in influence. At 5 years insulin, the homeostasis model assessment index and triglycerides were dependent on BW, current weight, and postnatal weight gain. In addition, BW was positively associated with high-density lipoproteincholesterol and inversely so to uric acid. A positive relationship among insulin, blood pressure values, and uric acid was observed even early in life.

Epidemiology of elevated blood pressure and associated risk factors in Chinese children: the SNEC study

“…Consistent with numerous studies, 28,29 our findings demonstrated that low birth weight and premature birth increased the risk of high BP. Low birth weight and prematurity are indicators of poor fetal development and are known as the most powerful clinical surrogates of low nephron endowment, which is an important cause of elevated BP.…”

Understanding the Power of Perinatal Events and Metabolic Status in Childhood

“…Data in the current report by Lurbe et al 2 suggest that metabolic variation may be a seminal mediating link as well. Regardless of weight gain, by age 5 years the SGA group was insulinresistant with lower high-density lipoprotein-cholesterol and higher uric acid levels, compared with the other birth weight groups.…”

“…in Brazil, Crispim et al 7 reported findings similar to those of Lurbe et al, 2 but their study was not prospective. Other issues of interest in the authors' study cohort include the rather high rates of obesity at age 5 years.…”

“…Further epigenetic studies may be helpful to our interpretation of prospective studies such as Lurbe et al's. 2 One hopes that banking of cord blood samples may allow comparisons of physiological results to both genetic and epigenetic studies. To understand the phenomenon of perinatal programming, it will be necessary to take careful phenotypic observations such as those of the current study and pair them with molecular mechanisms.…”

2016 European Society of Hypertension guidelines for the management of high blood pressure in children and adolescents

“…The time immediately before and after birth may be a sensitive period in which multiple interactions between hemodynamic and metabolic parameters foreshadow the clustering of cardiometabolic risk factors later in life (101,102). A critical window of opportunity to modify programming may exist during pregnancy and throughout the first years of life when strategies aiming to reduce risk can be implemented.…”