International Journal of Epidemiology, Vol 26, 562-570, Copyright © 1997 by International Epidemiological Association
E Hennessy and E Alberman
BACKGROUND: Data from the study of the British 1958 birth cohort, National
Child Development Study (NCDS), has allowed wider investigation of the
relationship between retarded fetal growth and risk of adult hypertension.
METHODS: A history of self-reported hypertension was related to fetal
growth in 3308 parous cohort members. Fetal growth, the measure used, is
the difference in actual birthweight from that expected for the gestational
age and subsequent adult height. The relationships were investigated both
linearly and non-linearly adjusting for potential confounders. RESULTS:
After adjustment for confounding factors, including adult weight for
height, retarded fetal growth was associated with reported hypertension
particularly when not confined to pregnancy. The latter was also associated
with accelerated fetal growth, moderate or severe hypertension in the
mother when pregnant with the cohort member, being relatively taller than
your mother, and lack of educational qualifications. Hypertension confined
to pregnancy was more likely among women who were themselves firstborn or
older at childbirth. Neither maternal smoking during cohort's gestation nor
cohort member's gestational age had a significant effect. The results are
consistent with previous reports that fetal growth effects are less marked
if gestation is short. CONCLUSIONS: The relationships between fetal growth
and subsequent hypertension are extremely complex and variable, and need to
be studied allowing for deviations from growth potential. Adult weight for
height remains the strongest predictor of hypertension. The results suggest
that losing weight is likely to have the same proportional benefit in women
with and without a history of retarded fetal growth.
ARTICLES
The effects of own fetal growth on reported hypertension in parous women aged 33
Department of Environmental and Preventive Medicine, The Wolfson Institute of Preventive Medicine. St. Bartholomew's, London, UK.
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