title: Weight gain and hypertension at three years of age and older in extremely low birth weight infants.
abstract: OBJECTIVE
  To determine the prevalence and weight gain as a risk factor of hypertension (HTN) at three years of age and older among extremely low birth weight (ELBW) infants.
  
  
  METHODS
  Retrospective cohort study of all ELBW infants born and followed up at our institution over 15 years.
  
  
  RESULTS
  204 infants were followed up for [median (inter-quartile range)] 10.2 years (6.9-13.0). Their birth weight and gestational age were (mean±standard deviation) 758±149 g and 26.4±2.1 weeks respectively. At 3 years of age and older, the prevalence of HTN was 7.3% (15/204), and the prevalence of obesity was 13.2% (27/204). Obesity was more prevalent in children with than without HTN [33% (5/15) vs. 12% (22/189); p = 0.01]. In a regression analysis, body mass index (BMI) percentile at 3 years of age and older (p = 0.04) and increase in weight Z scores since birth (p = 0.008) were associated with a higher systolic blood pressure (SBP; R = 0.386, p <  0.001).
  
  
  CONCLUSIONS
  Obesity is prevalent in ELBW infants at three years of age and older, and it is significantly associated with hypertension. An increase in BMI percentile at ≥3 years of age, and the rate of weight gain since birth among ELBW infants are associated with an increase in SBP.
authors.affiliation: Departments of Pediatrics, Case Western Reserve University, The MetroHealth System, Cleveland, OH, USA.
authors.forename: M J
authors.initials: MJ
authors.lastname: Mhanna
authors.affiliation: Departments of Pediatrics, Case Western Reserve University, The MetroHealth System, Cleveland, OH, USA.
authors.forename: A M
authors.initials: AM
authors.lastname: Iqbal
authors.affiliation: Departments of Pediatrics, Case Western Reserve University, The MetroHealth System, Cleveland, OH, USA.|Internal Medicine, Case Western Reserve University, The MetroHealth System, Cleveland, OH, USA.|Epidemiology and Biostatistics, Case Western Reserve University, The MetroHealth System, Cleveland, OH, USA.|Information Services, Case Western Reserve University, The MetroHealth System, Cleveland, OH, USA.
authors.forename: D C
authors.initials: DC
authors.lastname: Kaelber
mesh_terms: D000293:Adolescent; D001794:Blood Pressure; D015992:Body Mass Index; D002648:Child; D002675:Child, Preschool; D003971:Diastole; D005260:Female; D005865:Gestational Age; D006801:Humans; D006973:Hypertension / Q000453:epidemiology* / Q000503:physiopathology; D052577:Infant, Extremely Low Birth Weight; D008297:Male; D009765:Obesity / Q000453:epidemiology*; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D013599:Systole; D015430:Weight Gain
keywords: Hypertension; extremely low birth weight; obesity; premature infants