Abstract
Background: Low birth weight due to fetal growth restriction is an established risk factor for hypertension later in life, but the effect of preterm birth is less well studied.
Methods: A population-based cohort study including 329,477 Swedish men conscripting for military service 1991–2001, using individually linked data from three national registres. Multipe logistic regression analyses were used to evaluate the risk of high systolic blood pressure (SBP; ≥the 90th percentile). Adjustments were done for perinatal and socioeconomic confounders.
Findings: here was an inverse relationship between gestational age and risk of high SBP at conscription. Compared to men born at term (gestational age 37–41 weeks) the adjusted odds ratio (OR) of high SBP increased to 2.58 (95% CI: 1.76–3.77) among men born extremely preterm (gestational age 24–28 weeks). Due to an interaction between gestational age and body mass index (BMI) at conscription, the cohort was stratified by gestational age. Compared to men born at term, obesity at conscription (BMI ≥30 kg/m2) was more strongly associated with high SBP among men born very preterm (gestational age 24–32 weeks). Among men born at term, small-for-gestational age was associated with an increased risk of high SBP (adjusted OR = 1.32, CI: 1.24–1.39). On the other hand, there was no blood pressure effect of being small-for-gestational age in the very preterm group (adjusted OR 0.99, CI:0.64–1.53).
Interpretation: reterm birth is the strongest perinatal risk factor for high SBP in young men. In particular, the combination of very preterm birth and later obesity is associated with a high risk of high SBP. In addition, being small-for-gestational age after preterm birth has no impact on later blood pressure. The association between preterm birth and blood pressure may have a different biological explanation than the established association between low birth weight at term and hypertension. Future research should consider that possibility.
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Johansson, S., Iliadou, A., Bergvall, N. et al. 123 Preterm Birth–A Strong and Independent Risk Factor or High Blood Pressure in Young Swedish Men. Pediatr Res 56, 485 (2004). https://doi.org/10.1203/00006450-200409000-00146
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DOI: https://doi.org/10.1203/00006450-200409000-00146