title: Big mother or small baby: which predicts hypertension?
abstract: According to the Barker hypothesis, intrauterine growth restriction and premature delivery adversely affect cardiovascular health in adult life. The association of childhood hypertension as a cardiovascular risk factor and birth weight has been understudied. In a prospective cohort study, the authors evaluated the effect of birth weight, gestational age, maternal prepregnancy body mass index (BMI), and child BMI z score at the time of enrollment on the systolic and diastolic blood pressure (BP) z score in 3024 (1373 women) consecutive outpatient clinic patients aged 2.05 to 18.58 years. The latest National Health and Nutrition Examination Survey (NHANES III) was used to calculate the age-dependent z scores. The median z scores of BMI (+0.48, range -6.96-6.64), systolic BP (+0.41, range -4.50-6.73), and diastolic BP (+0.34, range -3.15-+6.73) were all significantly greater than the NHANES III reference population. Systolic BP z score did not correlate with birth weight or gestational age, but did correlate with maternal prepregnancy BMI (r=.090, P<.0001) and BMI z score (r=.209, P<.0001). Diastolic BP z score positively correlated with birth weight (0.037, P=.044), gestational age (r=.052, P=.005), BMI z score(r=.106, P<.0001), and maternal prepregnancy BMI (r=.062, P=.0007). In contrast to what would be expected from the Barker hypothesis, the authors found no negative correlation between BP z score and birth weight or gestational age. This study suggests that a high BMI, a big mom, and a high birth weight are more important risk factors for hypertension during childhood than low birth weight or gestational age.
authors.affiliation: Department of Pediatrics, Division of Pediatric Nephrology, Children's Hospital, London, Ontario, Canada. guido.filler@lhsc.on.ca
authors.forename: Guido
authors.initials: G
authors.lastname: Filler
authors.forename: Abeer
authors.initials: A
authors.lastname: Yasin
authors.forename: Priya
authors.initials: P
authors.lastname: Kesarwani
authors.forename: Amit X
authors.initials: AX
authors.lastname: Garg
authors.forename: Robert
authors.initials: R
authors.lastname: Lindsay
authors.forename: Ajay P
authors.initials: AP
authors.lastname: Sharma
mesh_terms: D000293:Adolescent; D001724:Birth Weight / Q000502:physiology; D001794:Blood Pressure / Q000502:physiology; D015992:Body Mass Index; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D005865:Gestational Age; D006801:Humans; D006973:Hypertension / Q000453:epidemiology* / Q000503:physiopathology; D007230:Infant, Low Birth Weight / Q000502:physiology*; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age / Q000502:physiology*; D009035:Mothers; D009749:Nutrition Surveys; D011247:Pregnancy / Q000502:physiology*; D011446:Prospective Studies; D012189:Retrospective Studies; D012307:Risk Factors; D014481:United States