Clark P M, Atton C, Law C M, Shiell A, Godfrey K, Barker D J
Medical Research Council Environmental Epidemiology Unit, University of Southampton, Hampshire, United Kingdom.
Obstet Gynecol. 1998 Jan;91(1):103-7. doi: 10.1016/s0029-7844(97)00581-4.
To determine whether women who are poorly nourished in early pregnancy, as determined by triceps skinfold thickness, or who have poor pregnancy weight gain have offspring with higher blood pressure (BP).
We evaluated 296 11-year-old children born to women who had taken part in a study of nutrition in pregnancy. Women had been weighed at 18 and 28 weeks' gestation and had had their triceps skinfold thickness measured at 18 weeks. In our follow-up study, their children were weighed and had their BP recorded. Blood pressure was adjusted for weight, gender, ethnic group, cuff size, and time of measurement.
The children's mean (standard deviation [SD]) systolic BP was 106 (12) mmHg and their mean (SD) diastolic BP was 62 (7) mmHg. Maternal triceps skinfold thickness at 18 weeks' gestation and maternal pregnancy weight gain between 18 and 28 weeks' gestation were weakly inversely related to the children's BP. However, among women with triceps skinfold thickness at 18 weeks below the group median (15 mm), reduced pregnancy weight gain was associated with significantly higher BP in the offspring; systolic pressure increased by 11.3 mmHg (95% confidence interval [CI] 2.2, 20.4) and diastolic pressure by 10.1 mmHg (95% CI 3.2, 17.1) for each kilogram-per-week decrease in pregnancy weight gain.
In women who were poorly nourished in early pregnancy, reduced pregnancy weight gain was associated with higher BP in the 11-year-old offspring. We suggest that fetal adaptations to poor maternal nutrition lead to elevated BP in childhood but adequate maternal weight gain during pregnancy may protect against this.
通过肱三头肌皮褶厚度确定孕早期营养状况差或孕期体重增加不佳的女性所生后代是否具有更高的血压（BP）。
我们评估了参与孕期营养研究的女性所生的296名11岁儿童。这些女性在妊娠18周和28周时进行了称重，并在妊娠18周时测量了肱三头肌皮褶厚度。在我们的随访研究中，对她们的孩子进行了称重并记录了血压。血压根据体重、性别、种族、袖带尺寸和测量时间进行了调整。
孩子们的平均（标准差[SD]）收缩压为106（12）mmHg，平均（SD）舒张压为62（7）mmHg。妊娠18周时母亲的肱三头肌皮褶厚度以及妊娠18至28周期间母亲的孕期体重增加与孩子的血压呈弱负相关。然而，在妊娠18周时肱三头肌皮褶厚度低于组中位数（15mm）的女性中，孕期体重增加减少与后代血压显著升高有关；孕期体重增加每减少1千克/周，收缩压升高11.3mmHg（95%置信区间[CI] 2.2，20.4），舒张压升高10.1mmHg（95%CI 3.2，17.1）。
在孕早期营养状况差的女性中，孕期体重增加减少与11岁后代的血压升高有关。我们认为，胎儿对母体营养不良的适应会导致儿童期血压升高，但孕期母亲体重的适当增加可能会预防这种情况。
