HYPERTENSION AND ARTERIAL STIFFNESS IN PRETERM CHILDREN AND ADOLESCENTS

Abstract

Objective: The aim of the current study was to investigate the association between preterm birth and ambulatory blood pressure (BP) levels and arterial stiffness during childhood and adolescence. Design and method: In this prospective case control study we included children and adolescents born preterm (cases) and children born full-term (controls) aged 5–19 years old. The participants underwent measurement of somatometric characteristics, office BP, central systolic BP, ambulatory BP monitoring (ABPM) and assessment of carotid-femoral pulse wave velocity (PWV). According to the Body Mass Index (BMI), the study population was classified as preterm-normal BMI, preterm-overweight/obese, full term- normal BMI and full term-overweight/obese. Results: Overall, 74 children participated in the study with a mean age of 10.7 (±3.63) years old out of which 52 were preterm and 22 were full-term children. Preterm children presented higher night SBP z score values compared to controls (p < 0.05), but did not differ in other BP parameters. Preterm birth and BMI z score were predictors of night SBP z score. Preterm children also presented marginally higher PWV z score values (p = 0.06). Prematurity was an independent predictor of PWV z score. Estimated marginal means for PWV z score adjusted for age, sex, presence of kidney disease at birth, office BPs, night BPs, central SBP, and BMI z scores were significantly higher in preterm individuals compared to controls (0.703, 95%CI 0.431–0.975 versus -0.19, 95%CI -0.574–0.536, respectively, p = 0.027). Preterm children who were overweight presented the highest values of night SBP and PWV z score. Conclusions: Preterm birth is associated with higher nocturnal BP and increased arterial stiffness in childhood and adolescence. Early detection of hypertension and prevention of obesity in childhood could prevent future adverse health outcomes in individuals born preterm.