Department of Pediatrics, NYU School of Medicine, New York, New York.
Department of Ophthalmology, Georgetown University, Washington, District of Columbia.
J Hypertens. 2024 Aug 1;42(8):1399-1408. doi: 10.1097/HJH.0000000000003745. Epub 2024 Apr 23.
Although some studies have observed an association between birthweight and cardiovascular disease in adulthood, fewer have investigated whether birthweight is linked to cardiovascular health in early childhood. This study assesses the association between birthweight and cardiovascular outcomes in children 6 years of age.
Birthweight, blood pressure (BP), and markers of arterial stiffness in children, including brachial artery distensibility and carotid-femoral pulse wave velocity (cfPWV), were obtained from 324 participants in The Infant Development and the Environment Study, a prospective multisite pregnancy cohort. Birthweight was converted into sex-specific birthweight-for-gestational-age (bw/ga) z -scores based on the INTERGROWTH-21st standard. Following 2017 American Academy of Pediatrics guidelines, SBP and DBP were transformed into sex, age, and height-specific z -scores. Associations between birthweight and cardiovascular outcomes were assessed using nested multivariable linear regression models among the overall and sex-stratified samples.
Among the overall sample, bw/ga z -score was positively associated with cfPWV [b = 0.11 m/s, 95% confidence interval (CI): 0.01 m/s, 0.21 m/s] in crude and adjusted models. No associations between birthweight and cardiovascular outcomes were detected among the sex-stratified analyses.
Overall, birthweight was not related to cardiovascular outcomes in children 6 years old. However, infants born with a higher birthweight may be at risk for higher cfPWV in childhood. Early intervention in pregnant people at risk of delivering high birthweight infants may be warranted if results are replicated.
尽管一些研究观察到出生体重与成年人心血管疾病之间存在关联，但很少有研究调查出生体重是否与儿童早期的心血管健康有关。本研究评估了出生体重与 6 岁儿童心血管结局之间的关系。
从前瞻性多地点妊娠队列“婴儿发育与环境研究”中，获取了 324 名儿童的出生体重、血压（BP）和动脉僵硬度标志物，包括肱动脉可扩张性和颈动脉-股动脉脉搏波速度（cfPWV）。根据 INTERGROWTH-21 标准，将出生体重转换为性别特异性出生体重-胎龄（bw/ga）z 分数。根据 2017 年美国儿科学会指南，将 SBP 和 DBP 转化为性别、年龄和身高特异性 z 分数。在总体样本和性别分层样本中，使用嵌套多变量线性回归模型评估出生体重与心血管结局之间的关系。
在总体样本中，bw/ga z 分数与 cfPWV 呈正相关[b=0.11m/s，95%置信区间（CI）：0.01m/s，0.21m/s]，在粗模型和调整模型中均如此。在性别分层分析中，未发现出生体重与心血管结局之间存在关联。
总体而言，出生体重与 6 岁儿童的心血管结局无关。然而，出生体重较高的婴儿在儿童时期可能存在更高的 cfPWV 风险。如果结果得到复制，可能需要对有分娩高出生体重婴儿风险的孕妇进行早期干预。
