Kumar Rajesh, Bandyopadhyay Sutapa, Aggarwal Arun Kumar, Khullar Madhu
Department of Community Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
Int J Epidemiol. 2004 Feb;33(1):87-91. doi: 10.1093/ije/dyh239.
Fetal malnutrition has been proposed as a cause of higher blood pressure. However, some studies have shown no or little effect of birthweight on blood pressure. Confounding and selection bias have been a problem in some of the studies. The ideal approach for avoiding selection bias is to conduct a prospective cohort study with minimal loss during follow-up. Therefore, the relationship of birthweight with blood pressure was examined in a cohort born during 1992-1993.
A cohort of 214 babies, born to usual residents in 10 villages of Haryana state in India on weekdays from September 1992 to November 1993 whose birthweight had been recorded by a trained field worker within 24 hours of delivery, were followed up during 2000-2001. During the 7-8 year period, 17 children had died and 12 had migrated. A trained public health nurse examined the remaining 185 children and measured their weight, height, and blood pressure.
Mean birthweight was 2.7 kg and 21.1% had low birthweight (<2500 g). Current weight, height, and body mass index (BMI) were associated with birthweight (P < 0.05). Systolic blood pressure (SBP) increased significantly with rise in current weight and height. Relationship of SBP with birthweight seems to be a U-shaped distribution. Compared with the middle birthweight tertile group, in the lowest and highest birthweight groups boys have higher SBP in the higher BMI category (>or=13.5 kg/m(2)) and girls have higher SBP in both lower and higher BMI categories. ANOVA analysis showed that SBP and diastolic blood pressure (DBP) were not significantly different in birthweight tertile groups among boys, but for SBP the difference was statistically significant among girls (P = 0.03). However, multivariate linear regression analysis that included socioeconomic status and current anthropometeric measures (weight, height, BMI) revealed that birthweight is not associated with SBP or DBP, and the interaction between birthweight and gender was also not significant for SBP and DBP (P = 0.09).
The findings of this population-representative cohort from rural India with 94% follow-up suggest that birthweight is not associated with blood pressure among 7-8 year old children.
胎儿营养不良被认为是血压升高的一个原因。然而，一些研究表明出生体重对血压没有影响或影响很小。在一些研究中，混杂因素和选择偏倚一直是个问题。避免选择偏倚的理想方法是进行前瞻性队列研究，随访期间损失最小。因此，我们在一个1992 - 1993年出生的队列中研究了出生体重与血压的关系。
1992年9月至1993年11月工作日期间，印度哈里亚纳邦10个村庄的常住居民所生的214名婴儿，其出生体重由一名经过培训的现场工作人员在分娩后24小时内记录，于2000 - 2001年进行随访。在这7 - 8年期间，17名儿童死亡，12名儿童迁移。一名经过培训的公共卫生护士对其余185名儿童进行了检查，并测量了他们的体重、身高和血压。
平均出生体重为2.7千克，21.1%的儿童出生体重低（<2500克）。当前体重、身高和体重指数（BMI）与出生体重相关（P < 0.05）。收缩压（SBP）随着当前体重和身高的增加而显著升高。SBP与出生体重的关系似乎呈U形分布。与出生体重处于中间三分位数组相比，在最低和最高出生体重组中，男孩在较高BMI类别（≥13.5千克/平方米）时SBP较高，女孩在较低和较高BMI类别时SBP均较高。方差分析显示，男孩出生体重三分位数组之间的SBP和舒张压（DBP）无显著差异，但女孩的SBP差异具有统计学意义（P = 0.03）。然而，纳入社会经济地位和当前人体测量指标（体重、身高、BMI）的多变量线性回归分析显示，出生体重与SBP或DBP无关，出生体重与性别的交互作用对SBP和DBP也不显著（P = 0.09）。
来自印度农村的这个具有代表性的队列研究结果显示，94%的随访率表明7 - 8岁儿童的出生体重与血压无关。
