Oxford Cardiovascular Clinical Research Facility, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, UK.
Department of Pediatrics, Tulane University School of Medicine, New Orleans, LA, USA.
Int J Epidemiol. 2023 Dec 25;52(6):1870-1877. doi: 10.1093/ije/dyad084.
Preterm birth has been associated with increased risk of hypertension and cardiovascular disease later in adulthood, attributed to cardiovascular and metabolic alterations in early life. However, there is paucity of evidence from low- and middle-income countries (LMICs).
We investigated the differences between preterm (<37 weeks gestational age) and term-born individuals in birth length and weight as well as adult (18 and 20 years) height, weight and blood pressure in the Brazilian 1993 Pelotas birth cohort using linear regressions. Analyses were adjusted for the maternal weight at the beginning of pregnancy and maternal education and family income at childbirth. Additional models were adjusted for body mass index (BMI) and birthweight. Separate analyses were run for males and females. The complete sample was analysed with an interaction term for sex.
Of the 3585 babies included at birth, 3010 were followed up in adulthood at 22 years. Preterm participants had lower length and weight at birth. This difference remained for male participants in adulthood, but female participants were no shorter than their term counterparts by 18 years of age. At 22 years, females born preterm had lower blood pressures (systolic blood pressure -1.00 mmHg, 95%CI -2.7, 0.7 mmHg; diastolic blood pressure -1.1 mmHg, 95%CI -2.4, 0.3 mmHg) than females born at term. These differences were not found in male participants.
In this Brazilian cohort we found contrasting results regarding the association of preterm birth with blood pressure in young adulthood, which may be unique to an LMIC.
早产与成年后患高血压和心血管疾病的风险增加有关，这归因于生命早期的心血管和代谢改变。然而，来自中低收入国家（LMICs）的证据很少。
我们使用线性回归分析了巴西 1993 年佩洛塔斯出生队列中早产（<37 周胎龄）和足月出生个体在出生时的身长和体重以及成年（18 岁和 20 岁）身高、体重和血压方面的差异。分析调整了孕妇妊娠开始时的体重以及分娩时的母亲教育和家庭收入。在调整体重指数（BMI）和出生体重后，进行了额外的模型分析。分别对男性和女性进行了单独的分析。对完整的样本进行了分析，并加入了性别交互项。
在出生时的 3585 名婴儿中，有 3010 名在 22 岁时进行了成年随访。早产参与者出生时的身长和体重较低。这种差异在成年男性参与者中仍然存在，但女性参与者在 18 岁时并不比足月出生的女性更矮。在 22 岁时，与足月出生的女性相比，早产出生的女性收缩压低 1.00 毫米汞柱（95%CI -2.7，0.7 毫米汞柱）；舒张压低 1.1 毫米汞柱（95%CI -2.4，0.3 毫米汞柱）。这些差异在男性参与者中并未发现。
在本巴西队列中，我们发现早产与年轻成年人的血压之间的关联存在相反的结果，这可能是 LMIC 特有的。
