Key result
Current body mass index was the strongest predictor of adult blood pressure (1.29 mm Hg per kg/m2 in males), while birth weight had a negative direct effect on adult systolic blood pressure.
Why the study?
How do fetal and postnatal growth affect adult blood pressure at 31 years?
Cohort (n=5,198)
How do fetal and postnatal growth affect adult blood pressure at 31 years?
Effect estimate: standardised regression coefficient -0.08 (95% CI -0.14 to -0.03)
Both fetal growth and postnatal growth, particularly from adiposity rebound onwards, are important determinants of adult blood pressure.
Emphasizes current BMI monitoring for adult BP risk assessment; extends growth trajectory data but leaves causal effects open pending trials.
BACKGROUND: Fetal and postnatal growth have been associated with adult blood pressure (BP), but findings about the relative importance of growth at different stages of life on BP are inconsistent. METHODS: The study population comprised 5198 participants from the Northern Finland Birth Cohort 1966 with data on birth weight, height and weight measurements until adolescence, systolic and diastolic BP at 31 years and several covariates. Structural equation modelling was used in the analysis. RESULTS: Negative direct effects of birth weight on adult systolic BP were observed (standardised regression coefficients: -0.08 (-0.14 to -0.03) in males and -0.04 (-0.09 to 0.01) in females, equalling -1.99 (-3.32 to -0.65) and -1.01 (-2.33 to 0.32) mm Hg/kg, respectively). Immediate postnatal growth was associated with adult BP only indirectly via growth later in life. In contrast, growth from adiposity rebound onwards had large direct, indirect and total effects on adult BP. Current body mass index was the strongest growth-related predictor of adult BP (0.36 (0.30 to 0.41) in males and 0.31 (0.24, 0.37) in females, equalling 1.29 (1.09 to 1.48) and 0.81 (0.63 to 0.99) mm Hg/(kg/m(2)), respectively). CONCLUSIONS: Our path analytical approach provides evidence for the importance of both fetal growth and postnatal growth, especially from adiposity rebound onwards, in determining adult BP, together with genetic predisposition and behavioural factors.
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Kaakinen et al. (2014) conducted a cohort in adult blood pressure (n=5,198). Prenatal and postnatal growth was evaluated on adult systolic blood pressure (standardised regression coefficient -0.08, 95% CI -0.14 to -0.03). Current body mass index was the strongest predictor of adult blood pressure (1.29 mm Hg per kg/m2 in males), while birth weight had a negative direct effect on adult systolic blood pressure.
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