The association of gestational age and birth weight with blood pressure among children: a Chinese national study

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Abstract

Gestational age and birth weight are supposed to associate with childhood blood pressure but remains unclear. This study aimed to investigate the association between gestational age, birth weight, and blood pressure among Chinese children. In all, 49 357 children aged 6–18 years were included from a nationwide survey in China. Gestational age, birth weight, and socioeconomic data were collected by questionnaires. Systolic (SBP) and diastolic (DBP) blood pressure were objectively measured. The associations between birth measures and blood pressure were examined by multivariable linear regression and logistic regression. The prevalence of hypertension was 19.1%, 19.2%, and 21.0% in preterm, term, and post-term subgroups, and 20.1%, 19.1%, and 19.8% in low-, normal-, and high-birth-weight subgroups, respectively. Results showed significantly positive associations of gestational age with SBP, DBP, SBP z-score, and DBP z-score in the overall and term subgroup, but not in the preterm or post-term subgroup. Birth weight was inversely related to SBP, DBP, SBP z-score, and DBP z-score across the entire birth-weight spectrum, and the overall association was stronger in girls than in boys. Similar associations were found in diffident age subgroups. Children with high birth weight had decreased odds of hypertension (OR 0.84, 95% CI 0.77–0.92) after adjustment for covariates. Preterm birth increased the risk of high SBP only in boys. This study suggested that gestational age was positively associated with blood pressure only in term-born children. Birth weight had a negative association with childhood blood pressure across the whole range of birth weight.

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Acknowledgements

We would like to acknowledge the kindly support from all participated students, parents, local education, health staffs, and team members.

Funding

This study was supported by the special research grant for non-profit public service of the Ministry of Health in China (Grant No. 201202010), and the National Natural Science Foundation of China (Grant No. 81673193 and 81602862). MT, LC, and YC also received support from the Natural Science Foundation of Guangdong Province, China (Grant No. 2016A030310150), Guangdong Medical Science and Technology Research Fund (Grant No. A2015045), and Guangdong Natural Science Fund (Grant No. 2015A030313093).

Author information

Correspondence to Yinghua Ma or Yajun Chen.

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The authors declare that they have no conflict of interest.

Electronic supplementary material

Table S1. Linear regression estimated for the associations of gestational age and birth weight with the participants’ BP by gender

Table S2. Linear regression estimated for the associations of gestational age and birth weight with the participants’ BP z-score by gender

Table S3. Effect of gestational age and birth weigh on predicting the risk of children’s high blood pressure by logistic regression models by gender

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