Relton C L, Pearce M S, O'Sullivan J J
Institute of Health and Society, School of Clinical Medical Sciences (Child Health), University of Newcastle upon Tyne, Newcastle upon Tyne, UK.
J Hum Hypertens. 2008 May;22(5):352-7. doi: 10.1038/sj.jhh.1002319. Epub 2008 Jan 3.
This cross-sectional study investigates the relationship between gestational age and systolic blood pressure and pulse pressure in childhood. Blood pressure was measured in 483 schoolchildren, free from cardiovascular disease, aged between 6 and 16 years. Pulse pressure was estimated as the difference between the 24-h mean systolic and diastolic blood pressure values. Linear regression showed an inverse relationship between gestational age and mean 24-h systolic blood pressure (adjusted regression coefficient mm Hg per week gestation -0.631, 95% confidence interval (CI) -1.21 to -0.04, P=0.036). Further, linear regression showed a significant negative association between gestational age and log-transformed pulse pressure (adjusted antilog regression coefficient mm Hg per week of gestation -1.39, 95% CI -2.96 to -0.3, P=0.013), which after gender-specific analyses was found to be restricted to the girls in the study. The results of the present study suggest that low gestational age is associated with elevated systolic blood pressure and pulse pressure in childhood, the latter particularly in girls. This observation provides some support for the developmental origins of adult disease hypothesis-that adverse events in early life may have long-term consequences for cardiovascular health. However, as gestational age itself is unlikely to be the causal event in determining blood pressure control, further investigation is required, particularly with regard to the nutritional, physiological and molecular mechanisms that explain such epidemiological observations.
这项横断面研究调查了胎龄与儿童期收缩压和脉压之间的关系。对483名6至16岁无心血管疾病的学童进行了血压测量。脉压通过24小时平均收缩压和舒张压值之间的差值估算得出。线性回归显示胎龄与24小时平均收缩压呈负相关（调整后的回归系数为每孕周毫米汞柱-0.631，95%置信区间（CI）为-1.21至-0.04，P=0.036）。此外，线性回归显示胎龄与对数转换后的脉压之间存在显著负相关（调整后的反对数回归系数为每孕周毫米汞柱-1.39，95%CI为-2.96至-0.3，P=0.013），在按性别进行分析后发现，这种关联仅限于研究中的女孩。本研究结果表明，低胎龄与儿童期收缩压和脉压升高有关，脉压升高在女孩中尤为明显。这一观察结果为成人疾病发育起源假说提供了一些支持，即生命早期的不良事件可能对心血管健康产生长期影响。然而，由于胎龄本身不太可能是决定血压控制的因果事件，因此需要进一步研究，特别是关于解释此类流行病学观察结果的营养、生理和分子机制。
