Roberts Gehan, Lee Katherine J, Cheong Jeanie L Y, Doyle Lex W
aPremature Infant Follow-up Program at the Royal Women's Hospital bDepartment of Paediatrics cDepartment of Obstetrics and Gynaecology, University of Melbourne dMurdoch Children Research Institute, Melbourne, Australia.
J Hypertens. 2014 Mar;32(3):620-6. doi: 10.1097/HJH.0000000000000055.
Adult preterm survivors from the 1980s have higher blood pressure (BP) than term controls. Survival rates of extremely preterm (gestational age<28 weeks; EP) infants born after 1990 have increased, but whether they still have higher BP than term controls is unknown. This study compared the BP of contemporary EP survivors with term controls in late adolescence.
All EP adolescents and matched term controls born in 1991-92 in Victoria, Australia, were enrolled in a longitudinal study. At age 18 years, 24-h ambulatory BP was measured. Average BP was compared between EP and term groups, and predictors of BP in EP adolescents were examined.
BP data were obtained from 136 EP patients and 120 controls. EP patients on average had higher systolic, diastolic and mean BP than controls. The mean systolic difference over 24 h was 3.2 mmHg [95% confidence interval (CI) 0.1-6.4], 3.9 mmHg [95% CI 0.7-7.2] when awake, and 2.0 mmHg (95% CI 1.4-5.5) when asleep. Male sex and change in weight SD score from birth to 2 years were predictive of SBP (regression coefficients 6.2 (95% CI 1.8-10.6), P=0.006) and 2.0 (95% CI 0.2-3.8), P=0.032), respectively). SBP at age 8 was associated with BP at age 18 years.
Late adolescent EP survivors of the modern era have higher BP compared with term controls. This highlights the importance of long-term cardiovascular surveillance for this increasing group into adulthood.
20世纪80年代的成年早产幸存者血压高于足月儿对照。1990年后出生的极早产儿（胎龄<28周；EP）存活率有所提高，但他们的血压是否仍高于足月儿对照尚不清楚。本研究比较了当代EP幸存者与青春期晚期足月儿对照的血压。
所有1991 - 92年出生在澳大利亚维多利亚州的EP青少年及匹配的足月儿对照均纳入一项纵向研究。在18岁时测量24小时动态血压。比较EP组和足月儿组的平均血压，并检查EP青少年血压的预测因素。
获得了136例EP患者和120例对照的血压数据。EP患者的收缩压、舒张压和平均血压平均高于对照。24小时平均收缩压差值为3.2 mmHg [95%置信区间（CI）0.1 - 6.4]，清醒时为3.9 mmHg [95% CI 0.7 - 7.2]，睡眠时为2.0 mmHg（95% CI 1.4 - 5.5）。男性以及出生至2岁时体重标准差评分的变化分别是收缩压的预测因素（回归系数分别为6.2（95% CI 1.8 - 10.6），P = 0.006）和2.0（95% CI 0.2 - 3.8），P = 0.032）。8岁时的收缩压与18岁时的血压相关。
现代青春期晚期的EP幸存者血压高于足月儿对照。这凸显了对这一不断增加的群体进行长期心血管监测直至成年的重要性。
