Bergel E, Haelterman E, Belizán J, Villar J, Carroli G
Centro Rosarino de Estudios Perinatales, Rosario, Argentina.
Am J Epidemiol. 2000 Mar 15;151(6):594-601. doi: 10.1093/oxfordjournals.aje.a010247.
This study aims to determine whether variables reflecting an adverse intrauterine environment are associated with childhood blood pressure. The authors conducted a secondary analysis of data from a prospective cohort of children born to healthy, nulliparous women enrolled in a randomized controlled trial. A total of 518 children were traced in 1995-1996 from 614 eligible children born in a clinic in Rosario, Argentina. The outcome was systolic blood pressure at 5-9 years. Hemoglobin during pregnancy was positively associated with children's pressure. Other maternal characteristics during pregnancy (blood pressure, smoking, weight gain, weight at 20 weeks' gestation, and glycemia) and size at birth (birth weight, ponderal index, head circumference/length ratio, and small for gestational age) were not associated with children's pressure. Among children in the upper quartile of body mass index, there was a weak inverse correlation between birth weight and systolic pressure, and systolic pressure was 14.8 mmHg (95 percent confidence interval: 3.3, 26.4) higher in low birth weight children than in others. The main predictors of childhood pressure were childhood body mass index and maternal pressure outside pregnancy. In this healthy population, the authors found weak support for an association between variables reflecting an adverse fetal environment and childhood blood pressure. Low birth weight was a risk factor for high blood pressure only in overweight children.
本研究旨在确定反映不良宫内环境的变量是否与儿童血压相关。作者对参加一项随机对照试验的健康未生育女性所生儿童的前瞻性队列数据进行了二次分析。1995 - 1996年,从阿根廷罗萨里奥一家诊所出生的614名符合条件的儿童中追踪到了518名儿童。研究结果是5至9岁时的收缩压。孕期血红蛋白与儿童血压呈正相关。孕期其他母体特征(血压、吸烟、体重增加、孕20周时的体重和血糖)以及出生时的大小(出生体重、体重指数、头围/身长比和小于胎龄)与儿童血压无关。在体重指数处于上四分位数的儿童中,出生体重与收缩压之间存在微弱的负相关,低出生体重儿童的收缩压比其他儿童高14.8 mmHg(95%置信区间:3.3,26.4)。儿童血压的主要预测因素是儿童体重指数和母亲非孕期血压。在这个健康人群中,作者发现反映不良胎儿环境的变量与儿童血压之间的关联证据不足。低出生体重仅在超重儿童中是高血压的一个危险因素。