Department of Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Department of Epidemiology & Biostatistics, Zhejiang University School of Public Health, Hangzhou, China.
BMC Pediatr. 2019 Jul 31;19(1):264. doi: 10.1186/s12887-019-1638-9.
The relationship between birth weight and blood pressure has not been well explored in Chinese children and adolescents. The aim of this study was to investigate the relationship between birth weight and childhood blood pressure in China.
A total of 15324 children and adolescents (7919 boys and 7405 girls) aged 7-17 years were stratified into six birth weight groups. Analysis of covariance and binary logistic regression were used to analyse the relationship between birth weight and blood pressure while controlling for potential confounding factors, including age, gestational age, season of birth and area of residence.
The group with birth weights from 2500 to 2999 g had the lowest prevalence of hypertension (8.9%). Lower birth weight children (< 2000 g) had significantly higher systolic blood pressure (SBP) (106.00 ± 0.72, P = 0.017), and children with heavier birth weights also had higher SBP (3500-3999 g, 105.13 ± 0.17, P < .001; ≥ 4000 g, 105.96 ± 0.27, P < .001). No significant relationship was found between birth weight and diastolic blood pressure (DBP). The overall rate of hypertension was 10.8% (12.1% in boys and 9.4% in girls). The median weight group (2500-2999 g) had the lowest rate of hypertension (8.9%). Compared with children in the median weight group, children with lower birth weight had a higher prevalence of hypertension (< 2000 g, OR = 1.85, 95% CI = 1.25-2.74; 2000-2499 g, OR = 1.57, 95% CI = 1.15-2.13), and groups with higher birth weights also had higher risks of hypertension (3500-3999 g, OR = 1.22, 95% CI = 1.02-1.45; ≥ 4000 g, OR = 1.42, 95% CI = 1.16-1.74).
Excluding the confounding effect of obesity, a U-shaped relationship between birth weight and risk of hypertension was found in children and adolescents in Chinese cities. Birth weight significantly influences SBP but has a minimal effect on DBP. Further basic research on foetal development and programming may shed light on this phenomenon.
在中国儿童和青少年中，出生体重与血压之间的关系尚未得到充分研究。本研究旨在探讨中国儿童出生体重与儿童期血压之间的关系。
将 15324 名 7-17 岁的儿童和青少年（男 7919 名，女 7405 名）分为 6 个出生体重组。采用协方差分析和二项逻辑回归分析，在控制潜在混杂因素（包括年龄、胎龄、出生季节和居住地区）的情况下，分析出生体重与血压之间的关系。
出生体重在 2500-2999g 的组高血压患病率最低（8.9%）。出生体重较低的儿童（<2000g）的收缩压（SBP）明显较高（106.00±0.72，P=0.017），出生体重较重的儿童的 SBP 也较高（3500-3999g，105.13±0.17，P<0.001；≥4000g，105.96±0.27，P<0.001）。出生体重与舒张压（DBP）无显著关系。高血压总发生率为 10.8%（男 12.1%，女 9.4%）。中位数体重组（2500-2999g）的高血压发生率最低（8.9%）。与中位数体重组的儿童相比，出生体重较低的儿童高血压患病率更高（<2000g，OR=1.85，95%CI=1.25-2.74；2000-2499g，OR=1.57，95%CI=1.15-2.13），出生体重较高的儿童也有更高的高血压风险（3500-3999g，OR=1.22，95%CI=1.02-1.45；≥4000g，OR=1.42，95%CI=1.16-1.74）。
排除肥胖的混杂影响后，发现中国城市儿童和青少年的出生体重与高血压风险之间存在 U 形关系。出生体重显著影响 SBP，但对 DBP 的影响较小。进一步的胎儿发育和编程基础研究可能会揭示这一现象。
