Fetal, XXXX , and childhood growth and adult blood pressure: a longitudinal study from birth to 22 years of age.

@entity1 @entity1017 @entity101 @entity28
BACKGROUND: @entity1 who are small at birth tend to have higher blood pressure in later life. However, it is not clear whether it is fetal growth restriction or the accelerated postnatal growth that often follows it that leads to higher blood pressure. METHODS AND RESULTS: We studied blood pressure in 346 British @entity1 and @entity1 aged 22 years whose size had been measured at birth and for the first 10 years of life. Their childhood growth was characterized using a conditional method that, free from the effect of regression to the mean, estimated catch-up growth. @entity1 who had been small at birth but who gained weight rapidly during early childhood (1 to 5 years) had the highest adult blood pressures. Systolic pressure increased by 1.3 mm Hg (95% CI, 0.3 to 2.3) for every standard deviation score decrease in birth weight and, independently, increased by 1.6 mm Hg (95% CI, 0.6 to 2.7) for every standard deviation score increase in early childhood @entity1017 . Adjustment for adult body mass index attenuated the effect of early childhood @entity1017 but not of birth weight. Relationships were smaller for diastolic pressure. @entity1017 in the first year of life did not influence adult blood pressure. CONCLUSIONS: Part of the risk of adult @entity101 is set in fetal life. Accelerated @entity1017 in early childhood adds to this risk, which is partly mediated through the prediction of adult fatness. The primary prevention of @entity101 may depend on strategies that promote fetal growth and reduce childhood @entity28 .
