Early Weight Gain, Linear Growth, and Mid‐childhood Blood Pressure

Abstract

ObjectiveTo investigate relations of change in body mass index (BMI) and length/height during 4 early life age intervals (birth to 6mo, 6mo to 1y, 1 to 2y, and 2 to 3y) with mid‐childhood systolic blood pressure (SBP), and to evaluate for effect modification by birth size (birthweight‐for‐gestational age z‐score).MethodsWe studied 957 participants in Project Viva, an ongoing U.S. pre‐birth cohort. Using multivariable linear regression, we examined the associations of weight gain (change in body mass index [BMI] z‐score) change and linear growth (change in length/height z‐score) during each time period with mid‐childhood SBP, adjusting for maternal education, age, pre‐pregnancy BMI, and smoking; and child's age, sex, race/ethnicity, continuous birthweight‐for‐gestational age z‐score, and growth in preceding periods. We examined interaction of these growth measures with birth size according to small (<10th percentile of sex‐ and gestational‐age specific birthweight), appropriate (10th to <90th percentile), and large‐for‐gestational age (≥90th percentile).ResultsChildren were 7.9 ± 0.8 years at time of SBP assessment; 50.3% were girls and most were white (65%). Mean ± SD SBP was 94.4 ± 8.8 mmHg and DBP was 54.3 ± 5.7 mmHg. Each additional z‐score gain in BMI from birth to 6mo and 2 to 3y was associated with 0.81 (95% CI: 0.15, 1.46) and 1.61 (0.33, 2.89) mmHg higher systolic SBP, respectively. Gain in length from 1 to 2y was related to higher SBP among boys (2.24 [0.89, 3.60] mmHg per z‐score) but not girls (−0.18 [−1.60, 1.25] mmHg per z‐score). There was no evidence of effect modification by birth size.ConclusionsFaster gain in BMI during the first 6 postnatal months and in the preschool years may lead to higher SBP in mid‐childhood, regardless of size at birth. Strategies to reduce accrual of excess adiposity during early life may bring long‐term benefits for cardiovascular healthSupport or Funding InformationThis work was supported by the US National Institutes of Health (K24 HD069408, R37 HD 034568, P30 DK092924).