Gunay Fatih, Alpay Harika, Gokce Ibrahim, Bilgen Hulya
Department of Pediatrics, Marmara University Medical Faculty Hospital, Istanbul, Turkey.
Eur J Pediatr. 2014 Jun;173(6):751-6. doi: 10.1007/s00431-013-2242-x. Epub 2013 Dec 29.
Late-preterm birth is associated with higher rates of neonatal morbidity and mortality and higher health care utilization, but its impact on later life is not well known. In this study, we aimed to evaluate whether late-preterm birth affects blood pressure, renal function, and urinary protein excretion in children later in life. Sixty-five children aged 4 to 13 years born as late-preterm and 65 age- and sex-matched children born full term were evaluated with 24-h ambulatory blood pressure monitoring (ABPM), urinary microalbumin excretion (UAE), and glomerular filtration rate (GFR). All subjects underwent ABPM prospectively. For each gender, daytime, nighttime, and 24-h systolic and diastolic and mean blood pressures (SBP, DBP, and MAP) were transformed to standard deviation scores (SDS). Blood pressure profiles (SBP DBP, and MAP) were considered abnormal when the corresponding SDS values exceeded 1.63. Urinary microalbumin excretion was expressed as milligrams per day, and the value between 30 and 300 mg/day was defined as microalbuminuria (MA). There was no significant difference in the mean GFR and MA levels between late-preterm and term children. 24-h systolic BP SDS, daytime systolic BP SDS, nighttime systolic BP SDS, 24-h diastolic BP SDS, nighttime diastolic BP SDS, 24-h MAP BP SDS, daytime MAP BP SDS, and nighttime MAP BP SDS were found to be significantly higher in late-preterm children compared to term children.
We conclude that late-preterm children have higher BP levels, so those children should be followed up carefully by the pediatrician regarding probable hypertension in their future life.
晚期早产与新生儿发病率和死亡率较高以及医疗保健利用率较高相关,但其对后期生活的影响尚不清楚。在本研究中,我们旨在评估晚期早产是否会影响儿童后期生活中的血压、肾功能和尿蛋白排泄。对65名4至13岁晚期早产出生的儿童和65名年龄及性别匹配的足月出生儿童进行了24小时动态血压监测(ABPM)、尿微量白蛋白排泄(UAE)和肾小球滤过率(GFR)评估。所有受试者均前瞻性地接受了ABPM。对于每种性别,将日间、夜间以及24小时收缩压、舒张压和平均血压(SBP、DBP和MAP)转换为标准差分数(SDS)。当相应的SDS值超过1.63时,血压曲线(SBP、DBP和MAP)被视为异常。尿微量白蛋白排泄以每天毫克数表示,30至300毫克/天的值被定义为微量白蛋白尿(MA)。晚期早产儿童和足月儿童之间的平均GFR和MA水平无显著差异。与足月儿童相比,晚期早产儿童的24小时收缩压SDS、日间收缩压SDS、夜间收缩压SDS、24小时舒张压SDS、夜间舒张压SDS、24小时MAP血压SDS、日间MAP血压SDS和夜间MAP血压SDS显著更高。
我们得出结论,晚期早产儿童的血压水平较高,因此儿科医生应密切关注这些儿童未来生活中可能出现的高血压情况。