Lucas A, Morley R
MRC Dunn Nutrition Unit, Cambridge.
BMJ. 1994 Jul 30;309(6950):304-8. doi: 10.1136/bmj.309.6950.304.
To test whether nutrition early in infants' development programmes later blood pressure and whether the reported relation between low birth weight and later high blood pressure is due to poor nutrition or growth before full term.
Prospective randomisation of preterm infants to early diets differing greatly in nutrient content in four parallel multicentre trials, with blinded follow up 7.5-8 years later.
Neonatal units at Cambridge, Ipswich, King's Lynn, Norwich, and Sheffield.
758 children weighing under 1850 g at birth.
Blood pressure at age of 7.5-8 years.
There were major differences in nutrient intake from randomised diets (preterm formula v standard formula and preterm formula v donor breast milk; in each case with or without mother's milk), but follow up showed no differences in later blood pressure. Individual subjects showed large variation in protein and energy intakes and in growth performance, including degrees of growth failure seldom seen in utero, but these factors were also unrelated to later blood pressure.
Extremes of nutritional intake and growth performance in preterm infants do not programme later blood pressure at 7.5-8 years of age. These findings do not support the hypothesis that high blood pressure has early nutritional origins. We suggest that the long term rise in blood pressure reported in individuals who had low birthweight (at full term) is not, as previously speculated, due to poor fetal nutrition or growth as such.
检测婴儿早期发育阶段的营养状况是否会影响其日后的血压，以及低出生体重与日后高血压之间的关系是否归因于足月前的营养不良或生长情况不佳。
在四项平行多中心试验中，将早产儿前瞻性随机分配至营养成分差异极大的早期饮食组，7.5至8年后进行盲法随访。
剑桥、伊普斯威奇、金斯林、诺维奇和谢菲尔德的新生儿病房。
758名出生时体重低于1850克的儿童。
7.5至8岁时的血压。
随机饮食的营养摄入量存在显著差异（早产配方奶粉与标准配方奶粉，以及早产配方奶粉与捐赠母乳；每种情况均有或无母乳），但随访显示日后血压并无差异。个体在蛋白质和能量摄入量以及生长表现方面存在很大差异，包括子宫内罕见的生长发育迟缓程度，但这些因素也与日后血压无关。
早产儿极端的营养摄入和生长表现并不会影响其7.5至8岁时的日后血压。这些发现不支持高血压有早期营养起源的假说。我们认为，出生体重低（足月时）的个体中报告的血压长期升高，并非如先前推测的那样，是由于胎儿营养或生长不佳本身所致。
