Markus Juonala1, Michael M H Cheung, Matthew A Sabin, David Burgner, Michael R Skilton, Mika Kähönen, Nina Hutri-Kähönen, Terho Lehtimäki, Antti Jula, Tomi Laitinen, Eero Jokinen, Leena Taittonen, Päivi Tossavainen, Jorma S A Viikari, Costan G Magnussen, Olli T Raitakari. 1. aResearch Centre of Applied and Preventive Cardiovascular Medicine bDepartment of Medicine, University of Turku cDivision of Medicine dDepartment of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland eMurdoch Childrens Research Institute, Parkville fRoyal Children's Hospital gDepartment of Paediatrics, University of Melbourne hDepartment of Paediatrics, Monash University, Melbourne iBoden Institute of Obesity, Nutrition, Exercise and Eating Disorders, University of Sydney, Sydney, Australia jDepartment of Clinical Physiology kDepartment of Clinical Chemistry lFimlab Laboratories, University of Tampere, and Tampere University Hospital, Tampere mNational Institute of Health and Welfare, Finland nDepartment of Clinical Physiology, University of Eastern Finland, and Kuopio University Hospital, Kuopio oHospital for Children and Adolescents, University of Helsinki, Helsinki pDepartment of Pediatrics, Vaasa Central Hospital, Vaasa qDepartment of Children and Adolescents, Oulu University Hospital, PEDEGO Research Group, and Medical Research Center Oulu, University of Oulu, Oulu, Finland rMenzies Institute for Medical Research, University of Tasmania, Hobart, Australia.
Abstract
OBJECTIVES: Both fetal growth restriction and prematurity have been associated with elevated blood pressure (BP). However, their combined effects on adult BP are unclear. METHODS: Our analyses were based on 1756 participants in the population-based Cardiovascular Risk in Young Finns Study who had information on birth weight and gestational age, together with longitudinal data on cardiovascular risk markers from age 3-18 years in 1980 to age 34-49 years in 2011. Three groups were defined by birth data: those born at term (term); those born preterm (<37 weeks) with an appropriate birth weight (>-1 SD z score according to national sex and gestational week-stratified data) for gestational age (preterm appropriate birth weight for gestational age); and those born preterm with low birth weight (≤-1 SD z score) for gestational age [preterm small birth weight for gestational age (SGA)]. RESULTS: There were no differences between the three groups in BP at baseline, but at the 31-year follow-up (mean age 41 years), mean SBP in the preterm SGA group was 7.2 mmHg (95% confidence interval = 2.3-12.1 mmHg, P = 0.004) higher than the preterm appropriate birth weight for gestational age group and 7.3 mmHg (95% confidence interval = 5.2-9.4 mmHg, P < 0.0001) higher than the term group, adjusted for age and sex. In addition, preterm SGA individuals had a higher prevalence of adult hypertension compared with those born at term (36.9 vs. 25.4%; age, sex, and risk factors adjusted P = 0.006). CONCLUSION: These longitudinal data suggest that elevated BP levels associated with prematurity are more likely to be present in those with fetal growth restriction.
OBJECTIVES: Both fetal growth restriction and prematurity have been associated with elevated blood pressure (BP). However, their combined effects on adult BP are unclear. METHODS: Our analyses were based on 1756 participants in the population-based Cardiovascular Risk in Young Finns Study who had information on birth weight and gestational age, together with longitudinal data on cardiovascular risk markers from age 3-18 years in 1980 to age 34-49 years in 2011. Three groups were defined by birth data: those born at term (term); those born preterm (<37 weeks) with an appropriate birth weight (>-1 SD z score according to national sex and gestational week-stratified data) for gestational age (preterm appropriate birth weight for gestational age); and those born preterm with low birth weight (≤-1 SD z score) for gestational age [preterm small birth weight for gestational age (SGA)]. RESULTS: There were no differences between the three groups in BP at baseline, but at the 31-year follow-up (mean age 41 years), mean SBP in the preterm SGA group was 7.2 mmHg (95% confidence interval = 2.3-12.1 mmHg, P = 0.004) higher than the preterm appropriate birth weight for gestational age group and 7.3 mmHg (95% confidence interval = 5.2-9.4 mmHg, P < 0.0001) higher than the term group, adjusted for age and sex. In addition, preterm SGA individuals had a higher prevalence of adult hypertension compared with those born at term (36.9 vs. 25.4%; age, sex, and risk factors adjusted P = 0.006). CONCLUSION: These longitudinal data suggest that elevated BP levels associated with prematurity are more likely to be present in those with fetal growth restriction.
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