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Is fetal macrosomia related to blood pressure among adolescents? A birth cohort study in China

Journal of Human Hypertension volume 27, pages 686–692 (2013)Cite this article

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Abstract

Birth weight (BW) has effects on blood pressure (BP). In order to explore the effects of macrosomia on BP in childhood and in adolescence, a longitudinal cohort study was conducted in Wuxi, China. Subjects with BW ⩾4000 g, born in 1993–1995, were the exposed group; the unexposed comparisons were matched by year of birth and sex of infant, with BW of 2500–4000 g. Follow-ups in 2005–6 and 2011–12 were conducted, and height, weight and BP were measured by trained doctors. Multi-mixed models in SAS were used to control for repeated measures to explore the effects of fetal macrosomia on BP. At the inception of the cohort, 1595 pairs of participants were recruited. At the end, 1112 in the exposed group and 1126 in the unexposed group finished both follow-ups. Among adolescents, mean (s.d.) of systolic BP (SBP) was 110.83 (9.43) mm Hg, which was statistically significantly higher than that in the unexposed group (mean±s.d.: 109.33±9.26) mm Hg (P=0.0002). After adjusting the repeated measures and birth year, sex, mother’s occupation and delivery age, adding weight during pregnancy, hypertension during delivery, gestational age and parity, being a picky eater in childhood, the macrosomia group had higher SBP than the normal BW group; the parameter estimate value was 1.03 (s.e.=0.30). When BMI in childhood and BMI in adolescence were added in the multi-model, the estimated β was 0.71 (s.e.=0.29). No statistically significant effect of macrosomia was found on diastolic BP among adolescents in the multianalysis.

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Acknowledgements

We thank all colleagues who worked in the field. We are grateful for the help of Dr Khalid S Khan from Queen Mary University of London in revising the manuscript. The follow-up study received financial support from National Natural Science Foundation of China (No.81072364). The EBM-CONNECT Collaboration received funding from the European Union (Proposal no. 101377; Grant Agreement no. 247613); and EBM-CONNECT Canadian Collaborators received funding from the Canadian Institutes of Health Research.

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No funders played a role in the planning and execution of this work, or in the drafting of the manuscript.

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Author notes

  1. See Appendix.

Authors and Affiliations

  1. School of Public Health, Public Health Security Key Laboratory of the Ministry of Education, Fudan University, Shanghai, China

    Y Li, J Wu, J Yu & J Ren

  2. Department of Epidemiology and Social Science on Reproductive Health, National Population and Family Planning Key Laboratory of Contraceptive Drugs and Devices, Shanghai Institute of Planned Parenthood Research, Shanghai, China

    Y Li, J Wu, E Gao & J Ren

  3. Barts and the London School of Medicine, Queen Mary University of London, London, UK,

    C Meads

  4. Department of Obstetrics and Gynaecology, Beijing United Family Hospital, Beijing, China

    M Afnan

  5. Basic Medicine College, Shanghai University of Chinese Traditional Medicine, Shanghai, China

    F Rong

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Correspondence to J Wu or J Yu.

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Appendix

Appendix

The EBM-CONNECT (Evidence-Based Medicine Collaboration: Network for systematic reviews and guideline development research and dissemination) Collaboration (in alphabetical order by country) includes: L Mignini (Centro Rosarino de Estudios Perinatales, Argentina); P von Dadelszen, L Magee, D Sawchuck (University of British Columbia, Canada); E Gao (Shanghai Institute of Planned Parenthood Research, China); BW Mol, K Oude Rengerink (Academic Medical Centre, The Netherlands); J Zamora (Ramon y Cajal, Spain); C Fox, J Daniels (University of Birmingham, UK); and KS Khan, S Thangaratinam, C Meads (Barts and the London School of Medicine, Queen Mary University of London, UK).

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Li, Y., Wu, J., Yu, J. et al. Is fetal macrosomia related to blood pressure among adolescents? A birth cohort study in China. J Hum Hypertens 27, 686–692 (2013). https://doi.org/10.1038/jhh.2013.31

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