U-shaped relationship between birth weight and childhood blood pressure in China

Chong Lai,Di He,Chunxiu Gong,Chunlin Wang,Shaoke Chen,Geli Liu,Feihong Luo,Yimin Zhu,Li Liang,Feng Xiong,Yiyan Hu

doi:10.1186/s12887-019-1638-9

Abstract

BackgroundThe relationship between birth weight and blood pressure has not been well explored in Chinese children and adolescents. The aim of this study was to investigate the relationship between birth weight and childhood blood pressure in China.MethodsA total of 15324 children and adolescents (7919 boys and 7405 girls) aged 7–17 years were stratified into six birth weight groups. Analysis of covariance and binary logistic regression were used to analyse the relationship between birth weight and blood pressure while controlling for potential confounding factors, including age, gestational age, season of birth and area of residence.ResultsThe group with birth weights from 2500 to 2999 g had the lowest prevalence of hypertension (8.9%). Lower birth weight children (< 2000 g) had significantly higher systolic blood pressure (SBP) (106.00 ± 0.72, P = 0.017), and children with heavier birth weights also had higher SBP (3500–3999 g, 105.13 ± 0.17, P < .001; ≥ 4000 g, 105.96 ± 0.27, P < .001). No significant relationship was found between birth weight and diastolic blood pressure (DBP). The overall rate of hypertension was 10.8% (12.1% in boys and 9.4% in girls). The median weight group (2500–2999 g) had the lowest rate of hypertension (8.9%). Compared with children in the median weight group, children with lower birth weight had a higher prevalence of hypertension (< 2000 g, OR = 1.85, 95% CI = 1.25–2.74; 2000–2499 g, OR = 1.57, 95% CI = 1.15–2.13), and groups with higher birth weights also had higher risks of hypertension (3500–3999 g, OR = 1.22, 95% CI = 1.02–1.45; ≥ 4000 g, OR = 1.42, 95% CI = 1.16–1.74).ConclusionsExcluding the confounding effect of obesity, a U-shaped relationship between birth weight and risk of hypertension was found in children and adolescents in Chinese cities. Birth weight significantly influences SBP but has a minimal effect on DBP. Further basic research on foetal development and programming may shed light on this phenomenon.

Highlights

The relationship between birth weight and blood pressure has not been well explored in Chinese children and adolescents
After statistical adjustment for Body mass index (BMI), the mean increase in Systolic blood pressure (SBP) was reduced by 40.5%, which indicated that obesity was one of the leading determinants of high SBP [9]
We aimed to reveal the association between birth weight and childhood hypertension

Summary

Introduction

The relationship between birth weight and blood pressure has not been well explored in Chinese children and adolescents. The aim of this study was to investigate the relationship between birth weight and childhood blood pressure in China. Childhood hypertension has been considered a strong predicative factor for hypertension in adulthood. China is experiencing a huge increase in the prevalence of obesity among children and adolescents. Dong et al explored the relationship between BMI and blood pressure in Chinese children. After statistical adjustment for BMI, the mean increase in SBP was reduced by 40.5%, which indicated that obesity was one of the leading determinants of high SBP [9]. The residual increase suggested that some other important factors contributed to childhood hypertension

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