title: Life course structural equation model of the effects of prenatal and postnatal growth on adult blood pressure.
abstract: BACKGROUND
  Fetal and postnatal growth have been associated with adult blood pressure (BP), but findings about the relative importance of growth at different stages of life on BP are inconsistent.
  
  
  METHODS
  The study population comprised 5198 participants from the Northern Finland Birth Cohort 1966 with data on birth weight, height and weight measurements until adolescence, systolic and diastolic BP at 31 years and several covariates. Structural equation modelling was used in the analysis.
  
  
  RESULTS
  Negative direct effects of birth weight on adult systolic BP were observed (standardised regression coefficients: -0.08 (-0.14 to -0.03) in males and -0.04 (-0.09 to 0.01) in females, equalling -1.99 (-3.32 to -0.65) and -1.01 (-2.33 to 0.32) mm Hg/kg, respectively). Immediate postnatal growth was associated with adult BP only indirectly via growth later in life. In contrast, growth from adiposity rebound onwards had large direct, indirect and total effects on adult BP. Current body mass index was the strongest growth-related predictor of adult BP (0.36 (0.30 to 0.41) in males and 0.31 (0.24, 0.37) in females, equalling 1.29 (1.09 to 1.48) and 0.81 (0.63 to 0.99) mm Hg/(kg/m(2)), respectively).
  
  
  CONCLUSIONS
  Our path analytical approach provides evidence for the importance of both fetal growth and postnatal growth, especially from adiposity rebound onwards, in determining adult BP, together with genetic predisposition and behavioural factors.
authors.affiliation: Institute of Health Sciences, University of Oulu, Oulu, Finland Biocenter Oulu, Oulu, Finland Department of Epidemiology and Biostatistics, MRC-PHE Centre for Environment and Health, Imperial College London, London, UK.
authors.forename: Marika
authors.initials: M
authors.lastname: Kaakinen
authors.affiliation: Department of Obstetrics & Gynaecology, University of Cambridge, Cambridge, UK.
authors.forename: Ulla
authors.initials: U
authors.lastname: Sovio
authors.affiliation: Institute of Clinical Medicine/Obstetrics and Gynaecology, University of Oulu, Oulu, Finland Medical Research Center, Oulu University Hospital, Oulu, Finland.
authors.forename: Anna-Liisa
authors.initials: AL
authors.lastname: Hartikainen
authors.affiliation: Institute of Clinical Medicine/Obstetrics and Gynaecology, University of Oulu, Oulu, Finland Medical Research Center, Oulu University Hospital, Oulu, Finland Department of Children and Young People and Families, National Institute for Health and Welfare, Oulu, Finland.
authors.forename: Anneli
authors.initials: A
authors.lastname: Pouta
authors.affiliation: Biocenter Oulu, Oulu, Finland Medical Research Center, Oulu University Hospital, Oulu, Finland Institute of Clinical Medicine/Internal Medicine, University of Oulu, Oulu, Finland.
authors.forename: Markku J
authors.initials: MJ
authors.lastname: Savolainen
authors.affiliation: Biocenter Oulu, Oulu, Finland Medical Research Center, Oulu University Hospital, Oulu, Finland Institute of Biomedicine/Physiology, University of Oulu, Oulu, Finland.
authors.forename: Karl-Heinz
authors.initials: KH
authors.lastname: Herzig
authors.affiliation: Department of Epidemiology and Biostatistics, MRC-PHE Centre for Environment and Health, Imperial College London, London, UK.
authors.forename: Paul
authors.initials: P
authors.lastname: Elliott
authors.affiliation: Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London, UK.
authors.forename: Bianca
authors.initials: B
authors.lastname: De Stavola
authors.affiliation: Department of Mathematical Sciences, University of Oulu, Oulu, Finland.
authors.forename: Esa
authors.initials: E
authors.lastname: Läärä
authors.affiliation: Institute of Health Sciences, University of Oulu, Oulu, Finland Biocenter Oulu, Oulu, Finland Department of Epidemiology and Biostatistics, MRC-PHE Centre for Environment and Health, Imperial College London, London, UK Department of Children and Young People and Families, National Institute for Health and Welfare, Oulu, Finland Unit of Primary Care, Oulu University Hospital, Oulu, Finland.
authors.forename: Marjo-Riitta
authors.initials: MR
authors.lastname: Järvelin
mesh_terms: D000328:Adult; D001724:Birth Weight / Q000502:physiology; D001794:Blood Pressure / Q000235:genetics / Q000502:physiology*; D015992:Body Mass Index; D015331:Cohort Studies; D005260:Female; D047109:Fetal Development / Q000502:physiology*; D005387:Finland; D006128:Growth / Q000502:physiology*; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D012307:Risk Factors
keywords: BLOOD PRESSURE; Epidemiological methods; GROWTH; Life course epidemiology