Perinatal Factors Associated With Standardized Blood Pressure Percentiles for Children Aged 6 to 12 Years: The BOSHI Study

Q: What is the clinical evidence from this study?

Study design: Cohort. Population: Childhood elevated blood pressure (n=175). Intervention: Birth weight vs. Lower birth weight (continuous per 100-g increase). Primary outcome: Diastolic blood pressure percentile (per 100-g increase in birth weight) (MD -0.87, 95% CI -1.68 to -0.064, p=0.035).

Q: What does this research mean for the field?

Higher birth weight is associated with lower diastolic blood pressure percentiles in children aged 6 to 12 years. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

Hiroki Nobayashi; Seiya Izumi; Michihiro Satoh; Noriyuki Iwama; Takahisa Murakami; Go Kanzaki; Yutaro Iwabe; Yuya Suzuki; Mami Ishikuro; Nobuo Tsuboi; Taku Obara; Takayoshi Ohkubo; Takashi Yokoo; Hirohito Metoki

doi:10.1111/jch.70376

October 1, 2026Journal of Clinical HypertensionOpen Access

Perinatal Factors Associated With Standardized Blood Pressure Percentiles for Children Aged 6 to 12 Years: The BOSHI Study

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Key result

Higher birth weight linked to ~0.9-percentile lower diastolic blood pressure per 100 g in children.

MD -0.87
95% CI -1.68 to -0.064
P=0.035
n=175

Why the study?

Evidence of an association between maternal and perinatal factors and standardized childhood blood pressure percentiles in Japan remains limited.

Key Points

To examine the association between maternal and perinatal factors and age-, sex-, and height-standardized blood pressure percentiles among children aged 6 to 12 years in Japan.
Analyzed longitudinal data from 175 mother–offspring pairs in the BOSHI study in Japan with home blood pressure measurements.
Calculated standardized systolic and diastolic blood pressure percentiles based on age, sex, and height reference curves.
Performed crude and multivariable linear regression analyses adjusting for maternal age, maternal body mass index, primiparity, hypertensive disorders of pregnancy, and gestational age.
In multivariable analyses, higher birth weight was significantly associated with lower diastolic blood pressure percentiles (β = −0.87 percentile per 100-g increase; p = 0.035).
Higher birth weight showed an inverse association of similar magnitude with systolic blood pressure percentiles (β = −0.96 percentile per 100-g increase; p = 0.052 in multivariable Model 1).

Study Design

Type

Cohort (n=175)

Multicenter

No

Structured PICO

P

Population

175 mother-offspring pairs in Japan followed until the children reached 6 to 12 years of age (median 7 years) to evaluate the association between perinatal factors and standardized childhood home blood pressure percentiles.

O

Outcome

Standardized childhood blood pressure percentiles (systolic and diastolic) based on age-, sex-, and height-specific percentiles at follow-up (6 to 12 years of age)surrogate

Main Result

Mean Difference: -0.87 (95% CI -1.68–-0.064)

p-value: p=0.035

Higher birth weight was independently associated with lower diastolic blood pressure percentiles in children aged 6 to 12 years, suggesting perinatal growth factors may influence long-term blood pressure trajectories.

Limitations

Small sample size, which may have reduced statistical power.
Limited representation of children aged 9-12 years, limiting generalizability.
Substantial reduction in participants from the original cohort, raising the possibility of selection bias.
Children's blood pressure percentiles were calculated using U.S. population references, which may not be entirely appropriate for Japanese children.
Reference values were derived from office rather than home blood pressure measurements.
Small sample size, which may have reduced statistical power
Substantial reduction in participants from the original cohort, raising the possibility of selection bias
Children's BP percentiles were calculated using U.S. population reference values which may not be entirely appropriate for Japanese children
AAP reference values were derived from office rather than home BP measurements

Implication

May link higher birth weight to lower childhood diastolic BP percentiles; hypothesis-generating and requires prospective validation.

Abstract

Elevated childhood blood pressure (BP) is associated with adulthood cardiovascular mortality. However, evidence of an association between maternal and perinatal factors and standardized childhood BP percentiles in Japan remains limited. In this study, we examined this association by using data from the BOSHI study, which included children's home BP measurements. Among 175 mother–offspring pairs, the mean maternal age and children's birth weight were 32.4 years and 3031 g, respectively; the median age of the children at follow‐up was 7 years; and hypertensive disorders of pregnancy occurred in 43 mothers. Multivariable analyses showed that higher birth weight was associated with lower diastolic BP percentiles (−0.87 percentile per 100‐g increase; p = 0.03). Given previous evidence linking elevated childhood BP to subsequent cardiovascular risk later in life, our findings warrant further investigation in diverse populations.

Discussion

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Cite This Study

Nobayashi et al. (2026) conducted a cohort in Childhood elevated blood pressure (n=175). Birth weight vs. Lower birth weight (continuous per 100-g increase) was evaluated on Diastolic blood pressure percentile (per 100-g increase in birth weight) (MD -0.87, 95% CI -1.68 to -0.064, p=0.035). Higher birth weight was significantly associated with lower standardized diastolic blood pressure percentiles in children aged 6 to 12 years (decrease of 0.87 percentile per 100-g increase in birth weight).

synapsesocial.com/papers/6ace6e0db52af824ab02bc9a https://doi.org/10.1111/jch.70376

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Perinatal Factors Associated With Standardized Blood Pressure Percentiles for Children Aged 6 to 12 Years: The BOSHI Study

Key Points

Study Design

Structured PICO

Main Result

Limitations

Implication

Abstract

Discussion

Cite This Study

Perinatal Factors Associated With Standardized Blood Pressure Percentiles for Children Aged 6 to 12 Years: The BOSHI Study

Key Points

Study Design

Structured PICO

Main Result

Limitations

Implication

Abstract

Discussion

Cite This Study

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