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Early predictors of hypertension in prematurely born adolescents
Author(s) -
Vohr Betty R,
Allan Walter,
Katz Karol H,
Schneider Karen C,
Ment Laura R
Publication year - 2010
Publication title -
acta pædiatrica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 115
eISSN - 1651-2227
pISSN - 0803-5253
DOI - 10.1111/j.1651-2227.2010.01926.x
Subject(s) - medicine , blood pressure , birth weight , diastole , pediatrics , randomized controlled trial , obstetrics , pregnancy , genetics , biology
Objective:  To assess the blood pressure of former preterm and term matched adolescent controls and to identify risk factors associated with blood pressure at 16 years. Design:  Observational cohort study. Secondary analysis of a randomized clinical trial. Setting:  Three academic centres participating in the Multicenter Indomethacin IVH Prevention Trial. Participants:  A total of 296 children born in 1989–1992 with birth weights 600 to <1250 g who participated in the Multicenter Indomethacin IVH Prevention Trial and 95 term controls were evaluated at 16 years. Main outcome measures:  Blood pressure and predictors of blood pressure. Results:  The adjusted mean difference in blood pressure for preterm adolescents was 5.1 mm Hg; p = 0.002 for systolic and 2.1 mm Hg; p = 0.027 for diastolic blood pressure. Among preterms, the primary predictors of increased systolic blood pressure were weight gain velocity between birth and 36 months (b = 8.54, p < 0.001), pre‐eclampsia (b = 5.67, p = 0.020), non‐white race (b = 3.77, p = 0.04) and male gender (b = 5.09). Predictors of diastolic blood pressure were weight gain velocity between birth and 36 months (b = 4.69, p = 0.001), brain injury (b = 6.51, p = 0.002) and male gender (b = −2.4, p = 0.02). Conclusions:  Early programming secondary to increased early weight gain velocity, intrauterine stress and neonatal brain injury may all contribute to risk of increased blood pressure among former preterm adolescents.

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