Effect of birth weight on life-course blood pressure levels among children born premature

Juonala, Markus; Cheung, Michael; Sabin, Matthew A.; Burgner, David; Skilton, Michael R.; Kähönen, Mika; Hutri‐Kähönen, Nina; Lehtimäki, Terho; Jula, Antti; Laitinen, Tomi; Jokinen, Eero; Taittonen, Leena; Tossavainen, Päivi; Viikari, Jorma; Magnussen, Costan G.; Raitakari, Olli T.

doi:10.1097/hjh.0000000000000612

Cited by 71 publications

(57 citation statements)

References 29 publications

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“…Our studies, however, are aligned with the recent large longitudinal study (n = 1756), where preterm AGA and preterm FGR were separated. 44 In this study, although there were no differences identified in blood pressure between 3 and 18 years of age, higher blood pressure was identified between 34 and 49 years of age. 44 It is possible in the group of children we studied, that blood pressure differences caused by either preterm birth or FGR or the combination of both may emerge later in life, which may make this age group an ideal window to target preventive care for cardiovascular risk, if indeed this group goes on to have higher blood pressure later in life.…”

Section: Baseline Blood Pressure and Heart Rate During Sleepcontrasting

confidence: 60%

Sleep: A Window Into Autonomic Control in Children Born Preterm and Growth Restricted

Yiallourou

Wallace

Whatley

et al. 2017

Sleep

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Study Objectives: Preterm birth and fetal growth restriction (FGR) are both associated with risk of hypertension in adulthood. Mechanisms leading to this pathology are unclear. In children aged 5-12 years, who were born preterm and FGR, we used sleep as a tool to assess autonomic control with assessment of cardiovascular structure and function. Methods: Eighteen children born preterm and FGR, 15 children born preterm with appropriate birth weights for gestational age (AGA), and 20 AGA term-born children were studied. Children underwent overnight polysomnography with the addition of continuous noninvasive blood pressure (Finometer™). Spectral measures of heart rate variability (HRV), blood pressure variability (BPV), and baroreflex sensitivity were assessed and overnight urinary catecholamine levels measured. Echocardiographic studies (Vivid7, GE Healthcare) were performed and vascular compliance assessed (Miller Instruments™). Statistical comparisons were adjusted for age and body size. Results: Compared to term children, preterm AGA children had increased high frequency HRV (p < .05) and BPV (p < .05) during sleep, reflecting increased parasympathetic activation and blood pressure changes related to respiration. Preterm FGR children had smaller left ventricular lengths, ascending aorta, and left ventricular outflow tract diameter (p < .05 for all) and vascular compliance was positively correlated with gestational age (r 2 = 0.93, p < .05). Conclusions: FGR combined with preterm birth did not alter autonomic control but altered heart structure in children. In contrast, preterm birth alone altered autonomic control but had no change in heart structure. These changes in children born preterm and FGR may contribute, in part, to increased risk of cardiovascular disease later in life but by different mechanisms.

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Section: Baseline Blood Pressure and Heart Rate During Sleepcontrasting

confidence: 60%

Sleep: A Window Into Autonomic Control in Children Born Preterm and Growth Restricted

Yiallourou

Wallace

Whatley

et al. 2017

Sleep

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“…One consistent observation was that adults born preterm had significantly higher systolic and diastolic blood pressure values, ranging between 2 and 8 mmHg, compared to their age‐matched term controls . A significantly higher prevalence of hypertension was also reported in one study , but this finding was not consistent. A report from the Adults Born Preterm International Coalition provided precise estimates of blood pressure changes.…”

Section: System/organ‐specific Outcomesmentioning

confidence: 87%

“…In 9 of 126 reports, SGA cohorts were included , and in two others, IUGR cohorts were included . These reports also contained outcomes for adults born preterm who were not SGA.…”

Section: System/organ‐specific Outcomesmentioning

confidence: 99%

Adults born preterm: a review of general health and system-specific outcomes

et al. 2017

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In this review of 126 publications, we report that an overwhelming majority of adults born at preterm gestations remain healthy and well. However, a small, but a significant fraction of them remain at higher risk for neurological, personality and behavioural abnormalities, cardio-pulmonary functional limitations, systemic hypertension and metabolic syndrome compared to their term-born counterparts. The magnitude of increased risk differed across organ systems and varied across reports. The risks were proportional to the degree of prematurity at birth and seemed to occur more frequently among preterm infants born in the final two decades of the 20th century and later. These findings have considerable public health and clinical practice relevance.

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“…Our data could not confirm that being small for gestational age at birth is a perinatal risk factor for high BP in children born extremely preterm. Over a life‐course perspective, being born small for gestational age has been considered to be more harmful in terms of risk of hypertension than preterm birth . However, life‐course studies of historic perinatal cohorts may be biased by selective survival among those born preterm and do not contain today's survivors born after extremely short gestations.…”

Section: Discussionmentioning

confidence: 99%

Blood Pressure in 6‐Year‐Old Children Born Extremely Preterm

Bonamy

Mohlkert

Hallberg

et al. 2017

JAHA

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BackgroundAdvances in perinatal medicine have increased infant survival after very preterm birth. Although this progress is welcome, there is increasing concern that preterm birth is an emerging risk factor for hypertension at young age, with implications for the lifetime risk of cardiovascular disease.Methods and ResultsWe measured casual blood pressures (BPs) in a population‐based cohort of 6‐year‐old survivors of extremely preterm birth (<27 gestational weeks; n=171) and in age‐ and sex‐matched controls born at term (n=172). Measured BP did not differ, but sex, age‐, and height‐adjusted median z scores were 0.14 SD higher (P=0.02) for systolic BP and 0.10 SD higher (P=0.01) for diastolic BP in children born extremely preterm than in controls. Among children born extremely preterm, shorter gestation, higher body mass index, and higher heart rate at follow‐up were all independently associated with higher BP at 6 years of age, whereas preeclampsia, smoking in pregnancy, neonatal morbidity, and perinatal corticosteroid therapy were not. In multivariate regression analyses, systolic BP decreased by 0.10 SD (P=0.08) and diastolic BP by 0.09 SD (P=0.02) for each week‐longer gestation.ConclusionsSix‐year‐old children born extremely preterm have normal but slightly higher BP than their peers born at term. Although this finding is reassuring for children born preterm and their families, follow‐up at older age is warranted.

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Effect of birth weight on life-course blood pressure levels among children born premature

Abstract: These longitudinal data suggest that elevated BP levels associated with prematurity are more likely to be present in those with fetal growth restriction.

Cited by 71 publications

References 29 publications

Sleep: A Window Into Autonomic Control in Children Born Preterm and Growth Restricted

Sleep: A Window Into Autonomic Control in Children Born Preterm and Growth Restricted

Adults born preterm: a review of general health and system-specific outcomes

Blood Pressure in 6‐Year‐Old Children Born Extremely Preterm

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