International Journal of Epidemiology, Vol 28, 676-681, Copyright © 1999 by International Epidemiological Association
FC Barros and CG Victora
BACKGROUND: This paper studies the relationship between birthweight for
gestational age and blood pressure in adolescents aged 14-15 years in
southern Brazil. METHODS: A sample of 1076 adolescents belonging to a
cohort of over 6000 children born in 1982 in Pelotas, southern Brazil, was
studied in 1997. All households in a sample of 25% of the city's census
tracts were visited and all adolescents born in 1982 were interviewed,
weighed, and their blood pressures were measured twice. Data from the
adolescents were linked to the database through their names and dates of
births. RESULTS: High diastolic and systolic pressure (defined as >95th
percentile) were significantly more frequent among adolescents who were
born below the 10th percentile of birthweight for gestational age. No
association was found between high blood pressure and low birthweight or
preterm births. In a multiple linear regression analysis, the association
between birthweight for gestational age and blood pressure was not
statistically significant after adjusting for age, sex, skin colour and
family income. However, when the current body mass index and height were
added to the model both diastolic and systolic pressure were significantly
associated with birthweight for gestational age, and adolescents who were
small for gestational age at birth presented a mean elevation of 3.08 mmHg
for diastolic pressure and 2.89 mmHg for systolic pressure. CONCLUSIONS:
There is an inverse association between birthweight for gestational age and
blood pressure during adolescence. This association, however, is only
disclosed when the negative confounding effect of the body mass index is
controlled for. The same association is not found when the effects of
birthweight and gestational age on blood pressure are analysed separately.
It appears therefore that the elevation of blood pressure during
adolescence only occurs when there was intra-uterine growth retardation.
ARTICLES
Increased blood pressure in adolescents who were small for gestational age at birth: a cohort study in Brazil
Latin American Center for Perinatology and Human Development (CLAP) PAHO/WHO, Montevideo, Uruguay. barrosfe@clap.ops-oms.org
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