Pharoah P O, Stevenson C J, West C R
Department of Public Health, University of Liverpool.
Arch Dis Child Fetal Neonatal Ed. 1998 Sep;79(2):F114-8. doi: 10.1136/fn.79.2.f114.
To compare the blood pressure of very low birthweight infants with that of normal birthweight controls in adolescence.
A cohort of all infants of birthweight < or = 1500 g born to women resident in the county of Merseyside in 1980-1 was followed up at age 15 years with age, sex, and school matched controls. Growth indices and blood pressures were measured under standard conditions. The smoking history of mothers and children and their status for several socioeconomic variables were documented. In a matched pairs analysis systolic and diastolic blood pressures were compared for cases and controls before and after adjusting for height, weight, and body mass index.
There were 172 singleton 15 year old survivors of birthweight < 1500 g out of 40,321 live births of Merseyside residents in 1980-1. Of the 172 survivors, 128 (74%) who had no clinical disability and 11 (6%) with a clinical disability but attending normal schools, were assessed with individually matched age, sex, and school controls. Twenty three (13%) had a clinical disability and were attending special schools; these were assessed without controls. Ten (6%) children refused or were unavailable for assessment. The systolic blood pressure was significantly higher in cases than in controls; the mean of the difference was 3.2 mm Hg. The diastolic blood pressure was also higher in the cases, but the difference was not significant. The controls were significantly heavier (4.4 kg), taller (4.0 cm), with larger head circumference (1.5 cm) than the cases. The difference in body mass index was not significant. Adjusting for height, weight, or body mass index increased the difference in systolic blood pressure between cases and controls. There were no significant differences in the socioeconomic variables, but what differences did exist favoured the controls. There was also a higher prevalence of smoking among the children and the mothers of the cases than the controls.
The study supports the hypothesis that in adolescents variation in systolic blood pressure has its origins in fetal development. Some of the variation could be attributed to socioeconomic differences.
比较极低出生体重婴儿与正常出生体重对照者在青春期时的血压。
对1980 - 1年期间居住在默西塞德郡的妇女所生的所有出生体重≤1500克的婴儿进行队列研究，并在他们15岁时随访，对照组在年龄、性别和学校方面与之匹配。在标准条件下测量生长指标和血压。记录母亲和儿童的吸烟史以及他们在几个社会经济变量方面的状况。在配对分析中，在对身高、体重和体重指数进行调整前后，比较病例组和对照组的收缩压和舒张压。
在1980 - 1年默西塞德郡居民的40321例活产中，有172例出生体重<1500克的单胎15岁幸存者。在这172名幸存者中，128例（74%）无临床残疾，11例（6%）有临床残疾但就读于普通学校，对其进行了年龄、性别和学校个体匹配的对照评估。23例（13%）有临床残疾且就读于特殊学校；对这些病例未进行对照评估。10例（6%）儿童拒绝或无法接受评估。病例组的收缩压显著高于对照组；平均差值为3.2毫米汞柱。病例组的舒张压也较高，但差异不显著。对照组比病例组显著更重（4.4千克）、更高（4.0厘米）、头围更大（1.5厘米）。体重指数的差异不显著。对身高、体重或体重指数进行调整后，病例组和对照组之间收缩压的差异增大。社会经济变量方面无显著差异，但确实存在的差异有利于对照组。病例组儿童及其母亲的吸烟率也高于对照组。
该研究支持这样的假设，即青春期收缩压的差异源于胎儿发育。部分差异可归因于社会经济差异。
