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IJE Advance Access published online on November 27, 2008
International Journal of Epidemiology, doi:10.1093/ije/dyn242
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Published by Oxford University Press on behalf of the International Epidemiological Association © The Author 2008; all rights reserved.

A structural equation model of the developmental origins of blood pressure

D L Dahly1,2,*, L S Adair1,2 and K A Bollen2,3,4

1Department of Nutrition, University of North Carolina at Chapel Hill, USA.
2Carolina Population Center, University of North Carolina at Chapel Hill, USA.
3Department of Sociology, University of North Carolina at Chapel Hill, USA.
4Odum Institute, University of North Carolina at Chapel Hill, USA.

*Corresponding author. University of North Carolina at Chapel Hill, CB# 8120, University Square, 123 West Franklin Street, 107-B CPC South, Chapel Hill, NC 27516 2524, USA. E-mail: dahly{at}email.unc.edu.


  Abstract

Background Birth-size is a problematic proxy for the fetal environment, and regression models testing for associations between birth-size and blood pressure have been criticized.

Methods We modelled fetal environment as a latent variable determined by maternal height and arm fat area (AFA) during pregnancy using structural equation modelling. We tested for associations between latent fetal environment (LFE) and systolic blood pressure (SBP) while controlling for birth weight (BW) and current weight (CW). Data are from 1435 male and 1218 female young adult Filipinos (2005; mean age 21 years) enrolled in the Cebu Longitudinal Heath and Nutrition Survey, an ongoing, community-based study of a one-year birth cohort. Using AMOS 6.0, LFE was modelled as a determinant of BW, CW and SBP; CW was modelled as a determinant of SBP.

Results Overall model fit was excellent ({chi}2: 32.14, 27 df, P = 0.23). The estimated direct relationship between LFE and SBP was inverse for both males (–0.43 –0.26 –0.10) and females (–0.29 –0.18 –0.07).

Conclusions These results are consistent with the hypothesis that maternal height and AFA impact fetal development in a manner that is positively associated with fetal growth (as reflected by BW) and inversely associated with SBP in young adulthood.

Keywords Blood pressure, birth weight, structural equation model, developmental origins

Accepted 23 October 2008


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Y.-K. Tu
Commentary: Is structural equation modelling a step forward for epidemiologists?
Int. J. Epidemiol., April 1, 2009; 38(2): 549 - 551.
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