The association between intrauterine growth restriction in the full-term infant and high blood pressure at age 7 years: results from the Collaborative Perinatal Project.
OBJECTIVE
To use neonatal and placental anthropometry as proxy measures of intrauterine growth restriction (IUGR) and to relate these to blood pressure later in childhood.


METHODS
A post hoc analysis of full-term white and black children from the Collaborative Perinatal Project, followed from birth until age 7 years (n = 29,710). Blood pressure above the 90th percentile by gender and race was considered high blood pressure. Anthropometric measures at birth included birth weight, ponderal index (PI, birth weight/birth length(3)), head to chest circumference (HCC) ratio, and placental ratio percentage (PRP, placental weight(*)100/birth weight).


RESULTS
Among anthropometric measures, PI, HCC, and birth weight were not associated with high systolic blood pressure at age 7 years, but PRP was. In multiple logistic regression, high systolic blood pressure and widened pulse pressure were both predicted by increased PRP [odds ratio (OR) 1.03 and 1.04, P < 0.001] but not by birth weight, when adjusted for gender, race, and maternal education. High diastolic blood pressure was weakly predicted by birth weight (OR 1.10, P = 0.05) but not by PRP.


CONCLUSIONS
PRP is associated with an increased risk for high systolic blood pressure and pulse pressure later in childhood, whereas birth weight, PI, and HCC are not. The proportion of placental weight to birth weight is a useful marker of IUGR for studying the developmental origins of adult disease hypothesis.
Hemachandra
Anusha H
AH
Department of Pediatrics, Division of Neonatology, The Johns Hopkins University School of Medicine, Baltimore, MD, USA. hemachaa@mail.nih.gov
Klebanoff
Mark A
MA
Duggan
Anne K
AK
Hardy
Janet B
JB
Furth
Susan L
SL
D000328:Adult; D017668:Age of Onset; D000886:Anthropometry; D001724:Birth Weight; D002648:Child; D005260:Female; D047109:Fetal Development; D005317:Fetal Growth Retardation / Q000473:pathology / Q000503:physiopathology; D006801:Humans; D006973:Hypertension / Q000209:etiology* / Q000473:pathology / Q000503:physiopathology; D007231:Infant, Newborn; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D009929:Organ Size; D010920:Placenta / Q000033:anatomy & histology; D011247:Pregnancy; D011446:Prospective Studies; D011674:Pulse; D013599:Systole; D014481:United States