Gillman Matthew W, Rich-Edwards Janet W, Rifas-Shiman Sheryl L, Lieberman Ellice S, Kleinman Ken P, Lipshultz Steven E
Department of Ambulatory Care and Prevention, Harvard Medical School/Harvard Pilgrim Health Care, Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
J Pediatr. 2004 Feb;144(2):240-5. doi: 10.1016/j.jpeds.2003.10.064.
To investigate perinatal predictors of newborn blood pressure.
Among 1059 mothers and their newborn infants participating in Project Viva, a US cohort study of pregnant women and their offspring, we obtained five systolic blood pressure readings on a single occasion in the first few days of life. Using multivariate linear regression models, we examined the extent to which maternal age and other pre- and perinatal factors predicted newborn blood pressure level.
Mean (SD) maternal age was 32.0 (5.2) years, and mean (SD) newborn systolic blood pressure was 72.6 (9.0) mm Hg. A multivariate model showed that for each 5-year increase in maternal age, newborn systolic blood pressure was 0.8 mm Hg higher (95% CI, 0.2, 1.4). In addition to maternal age, independent predictors of newborn blood pressure included maternal third trimester blood pressure (0.9 mm Hg [95% CI, 0.2, 1.6] for each increment in maternal blood pressure); infant age at which we measured blood pressure (2.4 mm Hg [95% CI 1.7, 3.0] for each additional day of life); and birth weight (2.9 mm Hg [95% CI, 1.6, 4.2] per kg).
Higher maternal age, maternal blood pressure, and birth weight were associated with higher newborn systolic blood pressure. Whereas blood pressure later in childhood predicts adult hypertension and its consequences, newborn blood pressure may represent different phenomena, such as pre- and perinatal influences on cardiac structure and function.
探讨新生儿血压的围产期预测因素。
在参与“活力计划”（一项关于孕妇及其后代的美国队列研究）的1059名母亲及其新生儿中，我们在出生后几天内单次获取了五次收缩压读数。使用多元线性回归模型，我们研究了母亲年龄及其他产前和围产期因素对新生儿血压水平的预测程度。
母亲的平均（标准差）年龄为32.0（5.2）岁，新生儿的平均（标准差）收缩压为72.6（9.0）毫米汞柱。一个多元模型显示，母亲年龄每增加5岁，新生儿收缩压就会升高0.8毫米汞柱（95%置信区间为0.2至1.4）。除母亲年龄外，新生儿血压的独立预测因素还包括母亲孕晚期血压（母亲血压每升高一级，新生儿收缩压升高0.9毫米汞柱[95%置信区间为0.2至1.6]）；测量血压时的婴儿年龄（出生后每增加一天，收缩压升高2.4毫米汞柱[95%置信区间为1.7至3.0]）；以及出生体重（每千克出生体重使收缩压升高2.9毫米汞柱[95%置信区间为1.6至4.2]）。
母亲年龄较大、母亲血压较高以及出生体重较大与新生儿较高的收缩压相关。虽然儿童期后期的血压可预测成人高血压及其后果，但新生儿血压可能代表不同的现象，例如产前和围产期对心脏结构和功能的影响。
