Relation between birth weight and blood pressure: longitudinal study of infants and children.

Abstract

Objective--To study the relation between birth weight and systolic blood pressure in infancy and early childhood.

Design--Longitudinal study of infants from birth to 4 years of age.

Setting--A middle class community in the Netherlands.

Participants--476 Dutch infants born in 1980 to healthy women after uncomplicated pregnancies.

Main outcome measures--Systolic blood pressure and body weight measured at birth and at 3 months and 4 years of age; the relation between systolic blood pressure and birth weight as estimated by multiple regression models that include current weight and previous blood pressure and control for gestational age, length at birth, and sex.

Results--Complete data were available on 392 infants. At 4 years of age the relation between blood pressure and birth weight appeared to be U shaped; low and high birthweight infants had raised blood pressure. Current weight and previous blood pressure were also positively associated with blood pressure at that age. Low birthweight infants (birth weight [less than] 3100 g) had a greater gain in blood pressure and weight in early infancy. High birthweight infants (birth weight [greater than or equal to] 3700 g) had high blood pressure at birth, and weight and blood pressure tended to remain high thereafter.

Conclusions--Even among normal infants there seem to be subgroups defined by birth weight in which blood pressure is regulated differently. Future investigations are needed to examine the physiological basis of these differences. Studies of correlates of adult disease related to birth weight should investigate mechanisms related to increased risk separately in infants of low and high birth weight.

Introduction

An inverse relation between birth weight and cardiovascular disease in adulthood has been reported in retrospective cohort studies.[1] The suggestion has been made that blood pressure mediates this relation. Indeed an inverse relation between birth weight and blood pressure has been reported in children, adolescents, and adult.[2-4] Mechanisms for such a relation have been proposed[5] but are by no means agreed on.[6-8] Nevertheless, these findings raise the possibility that prenatal as well as postnatal factors are important in the aetiology of disorders in adulthood related to hypertension.

If prenatal factors and factors in early infancy contribute to disease in later life then examining prospectively their relation to blood pressure in the first years of life may help to elucidate this contribution. We examined the relation of birth weight to blood pressure in early infancy and childhood. We also studied the interrelation among birth weight, current body weight, and blood pressure to examine the postnatal effects of birth weight on blood pressure.

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