Associations between high birth weight, being large for gestational age, and high blood pressure among adolescents: a cross-sectional study
Associations between high birth weight, being large for gestational age, and high blood pressure among adolescents: a cross-sectional study
Renata Kuciene 0
Virginija Dulskiene 0
Jurate Medzioniene 0
0 Laboratory of Population Studies, Institute of Cardiology, Medical Academy, Lithuanian University of Health Sciences , Sukileliu 15, 50009 Kaunas , Lithuania
Purpose Low birth weight and being small for gestational age are associated with increased risk of cardiometabolic diseases. However, the results from the studies examining the associations between high birth weight (HBW), being large for gestational age (LGA), and high blood pressure (HBP) are inconsistent. The aim of this study was to evaluate the associations between HBW and being LGA alone and in combinations with body mass index (BMI) categories in adolescence and HBP among Lithuanian adolescents aged 12-15 years. Methods The participants with HBP (≥90th percentile) were screened on two separate occasions. Data on the BMI, birth weight (BW), gestational age, and BP were analyzed in 4598 adolescents. Adjusted odds ratios (aORs) with 95% confidence intervals (CI) for the associations were estimated using multivariate logistic regression models. Results The overall prevalence of HBW (>4000 g), being LGA, adolescent overweight/obesity, and HBP were 13.9, 10.4, 14.5, and 25.6%, respectively. After adjustment for age, sex, and BMI, significant positive associations were found between HBW and being LGA and HBP (HBW: aOR 1.34; 95% CI, 1.11-1.63; LGA: aOR 1.44; 95% CI, 1.16-1.79). After adjustment for age and sex and compared Virginija Dulskiene Jurate Medzioniene
High blood pressure; High birth weight; Large for gestational age; Overweight; Obesity; Adolescents
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* Renata Kuciene
to BW 2500–4000 g and being AGA (appropriate for
gestational age) with normal weight in adolescence, the
combinations that included both risk factors—HBW with
overweight/obesity and being LGA with
overweight/obesity—showed higher aORs (aOR 4.36; 95% CI, 3.04–6.26;
and aOR 5.03; 95% CI, 3.33–7.60, respectively) than those
with either of these risk factors alone did.
Conclusions HBW and being LGA were positively
associated with HBP in Lithuanian adolescents aged 12–15 years.
The highest odds of having HBP were observed for
subjects with both risk factors—neonatal HBW or being LGA
and overweight/obesity in adolescence.
High blood pressure is a serious, growing, and global
public health problem [1]. It is the leading risk factor for
cardiovascular and circulatory diseases (e.g., ischaemic heart
disease, rheumatic heart disease, ischaemic stroke,
haemorrhagic and other nonischaemic stroke, and hypertensive
heart disease) [2]. According to the World Health
Organization, HBP causes 7.5 million deaths per year worldwide
(about 13% of all deaths) [3]. A systematic review and a
meta-regression analysis including 55 studies with a total
of 122,053 adolescents have showed that the pooled
prevalence of HBP was 13% for boys and 9.6% for girls [4]. It
has been demonstrated that BP tracks significantly from
childhood to adulthood [5]. Research literature suggests
that HBP can be influenced by environmental factors and
genetic factors as well as interactions between these factors
[6].
It has also been established that obesity is associated
with an increased risk of cardiovascular and other
noncommunicable diseases among children, adolescents,
and adults [3, 7]. In Europe, the prevalence of obesity is
increasing in the general population, including women of
reproductive age and children born with HBW. Women
who are obese (particularly with a pre-pregnancy metabolic
syndrome or gestational diabetes) are at an increased risk
for adverse neonatal outcomes such as fetal macrosomia
and LGA neonates [7]. Scientific studies report that HBW
is associated with a higher risk of obesity in childhood and
adulthood, and can influence the development of
cardiovascular diseases [8].
The increasing scientific evidence of the
associations between HBW and hypertension or HBP has been
described and summarized in several systematic reviews
and meta-analyses [9, 10]. For example, Mu et al. found
that there is an inversely linear association between BW
and the risk of adult hypertension [9]. Zhang et al. reported
that HBW (BW ≥4000 g or ≥90th percentile for the
gestational age) was related to a higher risk of HBP and
hypertension in younger children, but with a lower risk in older
adults, compared to those with normal birth weight (BW
2500–4000 g or the 10th–90th percentiles for gestational
age) [10]. Even though epidemiological studies have
examined the association between HBW and HBP [11–13] or
hypertension [14, 15] among children and adolescents, the
results have been inconsistent.
The relationships between HBP and HBW among
adolescents have not been studied in Lithuania before. In
Lithuania, epidemiological studies indicated a high prevalence
of HBP in children [16], adolescents [17], and adults [18]. (...truncated)