Department of Epidemiology University of Groningen University Medical Center Groningen Groningen the Netherlands.
Department of Public Health Amsterdam Public Health Research Institute Amsterdam University Medical Center University of Amsterdam Amsterdam the Netherlands.
J Am Heart Assoc. 2020 Nov 17;9(22):e018089. doi: 10.1161/JAHA.120.018089. Epub 2020 Nov 10.
Background There is still uncertainty about the nature and relative impact of early determinants on childhood blood pressure. This study explored determinants of blood pressure at the age of 6 years in 2 Dutch birth cohorts. Methods and Results Results of hierarchical multiple linear regression analyses in GECKO (Groningen Expert Center for Kids With Obesity) Drenthe study (n=1613) were replicated in ABCD (Amsterdam Born Children and Their Development) study (n=2052). All analyses were adjusted for child's age, sex, height, and body mass index (BMI), and maternal education and subsequently performed in the combined sample. No associations were found between maternal smoking during pregnancy and childhood blood pressure. In the total sample, maternal prepregnancy BMI was positively associated with systolic blood pressure (SBP) (β [95% CI], 0.09 [0.02-0.16] mm Hg) and diastolic blood pressure (β [95% CI], 0.11 [0.04-0.17] mm Hg). Children of women with hypertension had higher SBP (β [95% CI], 0.98 [0.17-1.79] mm Hg). Birth weight standardized for gestational age was inversely associated with SBP (β [95% CI], -6.93 [-9.25 to -4.61] mm Hg) and diastolic blood pressure (β [95% CI], -3.65 [-5.70 to -1.61] mm Hg). Longer gestational age was associated with lower SBP (β [95% CI] per week, -0.25 [-0.42 to -0.08] mm Hg). Breastfeeding for 1 to 3 months was associated with lower SBP (β [95% CI], -0.96 [-1.82 to -0.09] mm Hg) compared with no or <1 month of breastfeeding. Early BMI gain from the age of 2 to 6 years was positively associated with SBP (β [95% CI], 0.41 [0.08-0.74] mm Hg) and diastolic blood pressure (β [95% CI], 0.37 [0.07-0.66] mm Hg), but no effect modification by birth weight was found. Conclusions Higher maternal prepregnancy BMI, maternal hypertension, a relatively lower birth weight for gestational age, shorter gestational age, limited duration of breastfeeding, and more rapid early BMI gain contribute to higher childhood blood pressure at the age of 6 years.
对于早期决定因素对儿童血压的性质和相对影响仍存在不确定性。本研究探讨了 2 个荷兰出生队列中 6 岁儿童血压的决定因素。
在 GECKO（格罗宁根儿童肥胖专家中心）Drenthe 研究（n=1613）中进行的分层多元线性回归分析结果在 ABCD（阿姆斯特丹出生的儿童及其发育）研究（n=2052）中得到了复制。所有分析均根据儿童的年龄、性别、身高和体重指数（BMI）进行了调整，随后在合并样本中进行了分析。母亲怀孕期间吸烟与儿童血压之间未发现关联。在总样本中，母亲孕前 BMI 与收缩压（SBP）（β[95%CI]，0.09[0.02-0.16]mmHg）和舒张压（DBP）（β[95%CI]，0.11[0.04-0.17]mmHg）呈正相关。患有高血压的女性的孩子 SBP 更高（β[95%CI]，0.98[0.17-1.79]mmHg）。胎龄标准化的出生体重与 SBP（β[95%CI]，-6.93[-9.25 至-4.61]mmHg）和舒张压（β[95%CI]，-3.65[-5.70 至-1.61]mmHg）呈负相关。胎龄较长与 SBP 较低（β[95%CI]每增加一周，-0.25[-0.42 至-0.08]mmHg）相关。与不进行母乳喂养或母乳喂养<1 个月相比，1 至 3 个月的母乳喂养与 SBP 较低有关（β[95%CI]，-0.96[-1.82 至-0.09]mmHg）。从 2 岁到 6 岁时 BMI 早期快速增长与 SBP（β[95%CI]，0.41[0.08-0.74]mmHg）和舒张压（β[95%CI]，0.37[0.07-0.66]mmHg）呈正相关，但未发现出生体重的影响有差异。
母亲孕前 BMI 较高、母亲高血压、胎龄相对较低、胎龄较短、母乳喂养时间有限以及 BMI 早期快速增长与 6 岁时儿童血压较高有关。
