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子痫前期与印度儿童人体测量指标和血压的关系。

Association of preeclampsia with anthropometric measures and blood pressure in Indian children.

机构信息

Mother and Child Health, Interactive Research School for Health Affairs, Bharati Vidyapeeth (Deemed to be) University, Katraj, Pune, India.

Dept. of Pediatrics, Bharati Hospital and Research Centre, Bharati Vidyapeeth (Deemed to be) University, Katraj, Pune, India.

出版信息

PLoS One. 2020 May 5;15(5):e0231989. doi: 10.1371/journal.pone.0231989. eCollection 2020.

Abstract

BACKGROUND AND OBJECTIVE

Birth weight and post-natal growth are important predictors of adult health. Preeclampsia (PE) is associated with low birth weight and may have long term effects on the health of the children. The current study aims to compare anthropometry and blood pressure between children of mothers with and without PE in an Indian cohort.

METHODS

We studied children born to women with (PE; n = 211) and without preeclampsia (non-PE; n = 470) at Bharati Hospital, Pune, India. Anthropometry and blood pressure were measured in children at 3-7 years of age. Weight and height Z-scores were calculated using the WHO 2006 growth reference. Independent t-tests were used to compare means between the two groups, and associations between preeclampsia and child outcomes were analyzed using multiple linear regression, adjusting for potential confounders.

RESULTS

Weight and height Z-scores (p = 0.04 and 0.008), and subscapular skinfold thickness (p = 0.03) were higher among children of PE compared with children of non-PE mothers. Systolic blood pressure was also higher in children of PE mothers (1.70 mmHg [95% CI 0.05, 2.90] p = 0.006). BMI and diastolic blood pressure did not differ between groups. In regression models adjusted for newborn weight and gestational age, current age and sex, and maternal height, BMI and socio-economic status, children of PE mothers had higher weight Z-score (0.27 SD [95%CI 0.06, 0.48] p = 0.01), height Z-score (0.28 SD [95%CI 0.09, 0.47] p = 0.005), and subscapular skinfold thickness (0.38 mm [95%CI 0.00, 0.76] p = 0.049). A trend for higher systolic blood pressure (1.59 mmHg [95%CI -0.02, 3.20] p = 0.053) in the children was also observed in the adjusted model. The difference in systolic blood pressure was attenuated after adjusting further for the child's weight and height (1.09 mmHg [95%CI -0.48, 2.67] p = 0.17). There was no evidence of differences in effects between boys and girls.

CONCLUSION

Children of PE mothers were taller and heavier, and had higher systolic blood pressure, partly explained by their increased body size, than children of non-PE mothers. In utero exposure to preeclampsia may increase the risk of future cardiovascular disease.

摘要

背景和目的

出生体重和产后生长是成人健康的重要预测因素。子痫前期(PE)与低出生体重有关,并且可能对儿童的健康产生长期影响。本研究旨在比较印度队列中患有和不患有子痫前期(PE)的母亲所生儿童的人体测量学和血压。

方法

我们研究了在印度浦那的 Bharati 医院出生的患有(PE;n=211)和不患有子痫前期(非-PE;n=470)的母亲的儿童。在 3-7 岁时测量儿童的人体测量学和血压。使用世界卫生组织 2006 年生长参考标准计算体重和身高 Z 分数。使用独立 t 检验比较两组之间的平均值,使用多元线性回归分析子痫前期与儿童结局之间的关联,调整潜在混杂因素。

结果

与非-PE 母亲的儿童相比,PE 母亲的儿童体重和身高 Z 分数(p=0.04 和 0.008)以及肩胛下皮褶厚度(p=0.03)更高。PE 母亲的儿童的收缩压也更高(1.70 mmHg [95%CI 0.05, 2.90] p=0.006)。两组之间的 BMI 和舒张压没有差异。在调整新生儿体重和胎龄、当前年龄和性别以及母亲身高、BMI 和社会经济地位的回归模型中,PE 母亲的儿童体重 Z 分数更高(0.27 SD [95%CI 0.06, 0.48] p=0.01),身高 Z 分数更高(0.28 SD [95%CI 0.09, 0.47] p=0.005),肩胛下皮褶厚度也更高(0.38 mm [95%CI 0.00, 0.76] p=0.049)。在调整后的模型中,PE 母亲的儿童收缩压也有升高的趋势(1.59 mmHg [95%CI -0.02, 3.20] p=0.053)。在进一步调整儿童体重和身高后,收缩压的差异减弱(1.09 mmHg [95%CI -0.48, 2.67] p=0.17)。没有证据表明男孩和女孩之间的影响存在差异。

结论

PE 母亲的儿童比非-PE 母亲的儿童更高、更重,并且收缩压更高,部分原因是他们的体型更大,而这可能增加了他们未来患心血管疾病的风险。宫内暴露于子痫前期可能会增加未来患心血管疾病的风险。

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