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2.5 岁极早产儿的高血压。

High blood pressure in 2.5-year-old children born extremely preterm.

机构信息

Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.

出版信息

Pediatrics. 2012 May;129(5):e1199-204. doi: 10.1542/peds.2011-3177. Epub 2012 Apr 2.

DOI:10.1542/peds.2011-3177
PMID:22473369
Abstract

OBJECTIVE

Adolescents and young adults born preterm have elevated blood pressure (BP). The objective of this study was to investigate if BP is elevated at 2.5 years of age after an extremely preterm birth (EXPT).

METHODS

In a regional subset of the national population-based cohort Extremely Preterm Infants in Sweden Study, BP at 2.5 years of age was studied in 68 survivors of EXPT (gestational age: 23.6-26.9 weeks; mean ± SD birth weight: 810 ± 164 g), and 65 matched controls born at term.

RESULTS

At follow-up at 2.5 years of corrected age, EXPT children had significantly higher systolic blood pressure (SBP) and diastolic blood pressure (DBP) z scores than controls born at term, according to pediatric BP nomograms by age, gender, and height. The proportion of SBP ≥90th percentile was 44% (30 of 68) in EXPT children and 23% (15 of 65) in controls (P = .01). In logistic regression analyses stratified according to gender, EXPT was associated with an odds ratio for a SBP ≥90th percentile of 3.32 (95% confidence interval: 1.25-8.81) among boys. The corresponding odds ratio among EXPT girls was 2.18 (95% confidence interval: 0.62-7.61). In EXPT children, SBP and DBP z scores were inversely correlated to catch-up growth from 36 weeks' postmenstrual age to follow-up at 2.5 years of age.

CONCLUSIONS

Children born extremely preterm have elevated office SBP and DBP at a corrected age of 2.5 years. This finding might have implications for their cardiovascular health later in life.

摘要

目的

早产儿和青少年的血压(BP)升高。本研究的目的是探讨极早产儿(EXPT)出生后 2.5 岁时 BP 是否升高。

方法

在瑞典全国基于人群的极早产儿婴儿研究的区域子集中,对 68 名 EXPT(胎龄:23.6-26.9 周;平均±SD 出生体重:810±164g)幸存者和 65 名足月出生的匹配对照组在 2.5 岁时进行了 BP 研究。

结果

在 2.5 年的校正年龄时,根据儿童 BP 年龄、性别和身高的正常图表,EXPT 儿童的收缩压(SBP)和舒张压(DBP)z 评分明显高于足月出生的对照组。SBP≥90 百分位的比例在 EXPT 儿童中为 44%(30/68),在对照组中为 23%(15/65)(P=0.01)。在按性别分层的逻辑回归分析中,EXPT 与 SBP≥90 百分位的比值比为 3.32(95%置信区间:1.25-8.81),男孩中为 3.32(95%置信区间:1.25-8.81)。EXPT 女孩的相应比值比为 2.18(95%置信区间:0.62-7.61)。在 EXPT 儿童中,SBP 和 DBP z 评分与从 36 周的校正年龄到 2.5 岁的随访期间的追赶生长呈负相关。

结论

极早产儿出生的儿童在 2.5 岁的校正年龄时,其办公室 SBP 和 DBP 升高。这一发现可能对他们以后的心血管健康产生影响。

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