O103 Antenatal and Neonatal Exposures and Childhood Hypertension: Findings From the Boston Birth Cohort

Background: Early-life factors impact the development of hypertension (HTN). Impact of antenatal exposures, prematurity and subsequent early life exposures (including those in the neonatal intensive care unit (NICU)) on the development of HTN warrants further investigation. Objective: 1. Expand our prior findings on the association of maternal cardiometabolic conditions with childhood HTN in the Boston Birth Cohort (BBC). 2.Investigate the combined association between prematurity and NICU exposures with childhood HTN. Methods: We analyzed factors associated with childhood HTN up to 18 years. HTN was defined according to national guidelines. Composite categories were created based on gestational age and NICU comorbidities. Chi-square and ANOVA tests were used for categorical and continuous variables, respectively. Regression analyses explored the association with HTN, while repeated measures analysis assessed BP percentiles. Results: We analyzed 2461 infants (695 preterm), with a total of 19,689 repeated BP measurements. Maternal pre-existing diabetes, older maternal age, maternal stress in index pregnancy and chronic maternal stress, were positively associated with childhood HTN, after adjusting for important covariables. HTN incidence (25.9% vs. 16.31%) was higher in children born preterm, with an inverse dose-response trend. Compared to children born term without NICU exposure, those born term with NICU stay (OR 1.65 CI: 1.03-2.65), and those born preterm with NICU stay even without complications (OR 1.84 CI:1.38-2.46) had higher odds of developing HTN. Preterm children with NICU stay had the highest odds of developing HTN (OR 2.36 CI: 1.38-4.04), if they also had one or more major comorbidities (sepsis, chronic lung disease, necrotizing enterocolitis and intraventricular hemorrhage). Repeated measures analysis further revealed a positive association of systolic and diastolic BP percentiles with maternal cardiometabolic conditions, prematurity, and presence of NICU complications. Results remained consistent after adjustment for child BMI. Conclusion: In this US minority cohort, we found various early life factors linked to childhood HTN. Notably, preterm infants with a history of major NICU complications were more likely to develop childhood HTN.