Associations between high birth weight, being large for gestational age, and high blood pressure among adolescents: a cross-sectional study

European Journal of Nutrition, Jan 2017

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 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.

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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 - * 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)


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Renata Kuciene, Virginija Dulskiene, Jurate Medzioniene. Associations between high birth weight, being large for gestational age, and high blood pressure among adolescents: a cross-sectional study, European Journal of Nutrition, 2017, pp. 1-9, DOI: 10.1007/s00394-016-1372-0